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EDITED  BY  HENRY  SUZZALLO 

PRESIDENT   OF  THE   UNIVERSITY   OF   WASHINGTON,   SEATTLE 

SPEECH  DEFECTS 

IN 

SCHOOL  CHILDREN 

AND 

HOW  TO  TREAT  THEM 

BY 

WALTER  BABCOCK   SWIFT,  A.B.,  S.B.,  M.D. 

CLINICAL  ASSISTANT  IN  LARYNGOLOGY,  HARVARD  UNIVERSITY  GRADU- 
ATE SCHOOL  OF  medicine;  ASSISTANT   IN    THE  LARYNGOLOGICAL 
DEPARTMENT,    SPEECH    CLINIC,    MASSACHUSETTS    GENERAL 
HOSPITAL,  BOSTON  ;  MEDICAL  SUPERVISOR  OF  SPEECH 
CLASSES  FALL   RIVER   PUBLIC   SCHOOLS  ;  INSTRUC- 
TOR IN  SPEECH  DISORDER  WHEELOCK 
SCHOOL,   BOSTON 
DIRECTOR   OF  THE   KINDERGARTEN   SPEECH   CLINIC 


HOUGHTON   MIFFLIN   COMPANY 

BOSTON,    NEW   YORK   AND   CHICAGO 


COPYRIGHT,   1918,  BY  WALTER  BABCOCK  SWXFT 
ALL  RIGHTS  RESERVED 


Sy4  S 


CAMBRIDGB  .  MASSACHUSETTS 
U   .   S  .   A 


r 

4 

>' 

<■ 

O 

^ 

o 

IN  MEMORY  OF  A  WISE  SYMPATHY 

CONSTANT  INTEREST  AND 

CHRISTIAN  GUIDANCE 

I  DEDICATE  MY  FIRST  BOOK  TO 

MY  MOTHER 

ISABELLA  BABCOCK  SWIFT 


CONTENTS 

Editor's  Introduction vii 

I.  Importance  of  Good  Habits  of  Speech     .      i 
n.  Methods  of  correcting  Defects  of  Speech    13 

III.  The  Elimination  of  Minor  Speech  Disor- 

ders      46 

IV.  How  THE  Teacher  may  acquire  a  Proper 

Standard  of  Speech 68 

V.  Speech  Improvement  in  Kindergarten  and 

Elementary  Grades 88 

VI.  Speech  Disorders  among  Abnormal  Chil- 
dren AND  HOW  to  treat  THEM        .        .        .Ill 

Outline  .     .     .     .     ,     . .    .     ,     .     .127 


EDITOR'S  INTRODUCTION 

The  school  system  has  grown  increasingly  flexi- 
ble during  the  last  twenty  years.  Its  effort  to 
adapt  itself  to  the  peculiar  problems  of  special 
groups  of  pupils  constitutes  one  of  its  most 
substantial  achievements  in  efficiency.  Special 
provisions  for  the  deaf  and  dumb,  the  blind,  the 
tubercular,  the  crippled,  the  mentally  defective, 
and  the  exceptionally  gifted  are  among  the  means 
now  employed  by  large  school  systems  to  equalize 
educational  opportunity.  In  each  case  initiative 
has  been  stimulated  the  moment  the  facts  of  a 
particular  neglected  need  have  been  adequately 
presented  to  the  school  administrator.  Then  ex- 
periment ensued,  followed  by  the  garnering  of 
experience's  best  results.  Once  the  program  of 
practical  procedure  has  been  evolved,  special 
teachers  have  been  trained  for  the  new  respon- 
sibility. Within  a  decade,  what  was  once  a  new 
and  somewhat  startling  innovation  has  become  a 
completely  accepted  tradition  of  the  schools.  This 
has  been  the  history  of  every  type  of  special  in- 
struction now  included  in  the  school  organization. 

vii 


EDITOR'S  INTRODUCTION 

At  this  moment  we  are  aware  of  another  special- 
ized responsibility,  one  to  which  schoolmasters 
have  been  more  than  half -blind  —  the  correction 
of  radical  speech  defects.  In  spite  of  all  our  theo- 
retic intent  in  the  teaching  of  reading  and  elocu- 
tion, we  have  done  nothing  for  the  unfortunate 
group  of  stammerers  and  stutterers  always  found 
in  the  school  system.  At  best  such  methods  as 
have  been  employed  in  these  traditional  studies 
have  been  without  basis  in  scientific  diagnosis 
and  treatment.  In  consequence  they  have  been 
worse  than  futile.  They  have  merely  permitted 
the  social  and  vocational  handicaps  of  the  afflicted 
to  persist  and  become  aggravated.  The  day  when 
we  may  continue  this  policy  has  passed.  We  have 
become  sensitive  to  om'  neglect  and  failure  and 
we  are  ready  to  adopt  a  program  for  the  pedagogi- 
cal care  of  speech  defects.  Already  we  face  a  de- 
mand for  accurate  information  upon  this  subject. 
More,  we  are  asking  for  practical  scientific  meth- 
ods in  the  reconstruction  of  the  speech  habits  of 
our  children. 

As  is  usually  the  case,  the  attempt  to  deal  with 
markedly  pathological  conditions  finally  focuses 
attention  upon  minor  disorders  that  usually  escape 
notice.  For  a  long  time  Americans  have  been 
told  that  they  possess  unpleasant  voices.    The 

viii 


EDITOR'S  INTRODUCTION 

monotony,  the  harshness,  the  nasality,  and  the 
slovenliness  of  American  speech  have  often  been 
called  to  our  attention,  most  frequently  by  those 
who  suffer  the  sudden  contrast  and  revelation  of 
coming  into  our  midst  after  years  of  life  among 
those  British  and  Latin  peoples  who  have  evolved 
a  more  congenial  set  of  speech  habits.  These 
lesser  handicaps,  aesthetic,  at  any  rate,  have  like- 
wise become  part  of  our  educational  problem  and 
consequently  part  of  the  responsibility  of  every 
school  teacher.  For  the  efficiency  of  every  Ameri- 
can classroom  teacher,  as  well  as  for  the  better 
development  of  special  teachers  of  correct  speech, 
the  editor  offers  a  volume  of  facts  and  methods 
on  the  correction  of  speech  difficulties.  It  is  with 
a  great  sense  of  relief  that  we  save  the  more  con- 
scientious of  teachers  the  baffling  task  of  trying 
to  collect  essential  wisdom  from  scattered  medi- 
cal and  pedagogical  treatises  upon  this  subject. 
It  is  with  a  confident  sense  of  service  that  we 
present  an  invaluable  work  by  an  eminent  medical 
specialist  with  experienced  insight  into  pedagogi- 
cal ways  and  means.  So  much  practical  informa- 
tion on  speech  correction  has  never  before  been 
made  accessible  to  teachers  in  such  handy  form. 


SPEECH  DEFECTS 
IN  SCHOOL  CHILDREN 


IMPORTANCE  OF  GOOD  HABITS  OF  SPEECH 

Speech  and  its  excellences  and  defects  are  more 
a  matter  of  habit,  more  the  impress  of  our  en- 
vironment, more  due  to  the  speech  we  have  per- 
sistently heard,  than  we  realize.  Observing  hab- 
its of  bad  utterance  years  after  they  have  become 
ingrained,  we  are  apt  to  lose  sight  of  the  long 
periods  during  which  they  have  been  running 
and  to  look  upon  them  as  matters  of  the  present 
moment  alone.  This,  however,  is  not  only  a  su- 
perficial but  a  false  view  of  the  matter.  If  our 
results  are  to  be  at  all  trustworthy,  we  must 
learn  to  consider  every  speech  problem  that  pre- 
sents itself  in  what  may  be  called  its  historical 
aspect.  Methods  used  for  eradication  of  bad  hab- 
its of  speech  must  be  based  upon  a  knowledge 
of  the  way  in  which  those  habits  were  formed. 
It  will  be  well,  therefore,  to  consider  some  of  the 
habits  of  early  childhood  before  turning  to  the 
broader  aspects  of  our  subject. 


SPEECH  DEFECTS  IN  CHILDREN 

/.  Speech  habits  of  childhood  hard  to 
eradicate 

As  we  review  the  history  of  speech  disorders 
through  the  long  years  of  their  persistence,  one 
of  the  first  things  that  we  discover  is  the  diffi- 
culty experienced  in  their  eradication.  Speech 
defects  are  always  hard  to  cure.  This  difficulty 
may  be  illustrated  in  numerous  ways.  Recall  the 
foreign  accent  that  remains  with  some  people 
and  marks  their  every  utterance.  A  foreign  ac- 
cent is  often  one  of  the  most  difficult  things  to 
live  down.  It  is  sometimes  impossible  to  cure. 
It  gives  a  good  illustration  of  the  difficulty  of 
eradicating  bad  habits  planted  in  early  childhood. 
Again,  consider  the  faulty  pronunciation  of  the 
letter  s  which  we  call  the  lisp.  This  is  simply 
one  of  those  bad  habits  started  in  childhood 
which  has  persisted  for  years  without  being  ehm- 
inated,  without  being  outgrown,  and  all  the 
years  of  faulty  pronunciation  have  so  deepened 
this  faulty  utterance  that  eradication  is  made 
very  hard;  in  fact,  the  difficulty  is  so  great  that 
one  speech  teacher  has  said  that  it  takes  a  year 
to  eradicate  a  marked  lisp.  Compare  this  to  the 
eradication  of  other  physical  defects,  such,  for 
example,  as  the  medical  man  removes  by  opera- 

2 


GOOD  HABITS  OF  SPEECH 

tion  or  by  a  short  course  of  medication.  Speech 
disorders  are  very  hard  to  cure  in  comparison 
with  other  more  or  less  quickly  removable  defects 
of  the  body. 

We  often  find  faulty  enunciation  of  a  number 
of  utterances  or  sounds.  The  difficulty  of  cure 
is  proportionately  increased.  An  illustration  of 
this  fact  is  seen  in  that  all  too  frequent  form  of 
speech  disorder  known  as  "baby  talk."  This  is 
simply  the  persistence  in  the  grown  person  of  a 
number  of  phonetic  defects  that  the  mother  has 
implanted  in  her  children  by  talking  "  baby  talk" 
to  them.  (I  have  known  cases  that  persisted  to 
the  age  of  twelve  and  fifteen  !  Most  frequently 
these  cases  were  eradicated  before  the  age  of 
eight  years,  but  occasionally  they  last  longer.) 
In  proportion  to  the  length  of  their  persistence 
is  their  depth  of  impression,  and  also  in  exactly 
this  proportion  is  the  difficulty  and  hardship  of 
their  eradication. 

In  this  connection  should  be  mentioned  un- 
clear speech.  I  mean  by  this,  not  an  obvious 
phonetic  defect,  but  a  general  lack  of  clear  dis- 
tinct utterance.  This,  too,  may  be  classed  as  a 
bad  habit  started  in  childhood  and  carried  along 
for  years  without  any  attempt  at  eradication.  It 
is  just  as  hard  to  eliminate  as  any  of  the  other 

3 


SPEECH  DEFECTS  IN  CHILDREN 

habits  of  speech  mentioned  above.  We  might 
also  mention  the  child's  imitation  of  its  parents' 
slovenly  speech.  Slovenly  speech  acquired  in  the 
yet  tender  years  may  take  a  long  time  to  replace 
by  that  technically  exact  and  clear-cut  utterance 
which  is  so  charming  in  the  finished  conversa- 
tionalist. 

Bad  grammar  is  mostly  a  matter  of  ear,  and 
may  be  classed,  as  to  hardship  of  eradication,  in 
the  same  category  with  the  smaller  and  less  ob- 
vious defects  mentioned  above.  Some  ungram- 
matical  habits  of  speech  are  so  deeply  fixed  that 
they  are  hardly  susceptible  of  eradication.  Thus 
we  see  that  without  exception  early  speech  hab- 
its are  hard  to  eradicate. 

2.  Some  become  permanent  defects 

It  is  well,  in  these  introductory  remarks,  to 
emphasize  the  fact  that  bad  habits  of  speech 
may  become  fixed  and  well-nigh  ineradicable. 
When  we  instill  the  fear  that  a  speech  disorder 
may  become  permanent,  then  we  give  a  powerful 
incentive  to  early  treatment ;  we  give  a  weighty 
reason  for  initiating  methods  of  prevention. 

Foreign  accent  becomes  permanent.  Slovenly 
speech  may  cling  to  one  throughout  life.  "  Baby 
talk"  occasionally  lasts  over  into  the  years  of 

4 


GOOD  HABITS  OF  SPEECH 

adult  life.  These  observations  are  seen  to  be 
truisms  when  we  study  the  past  histories  of  those 
who  are  troubled  with  speech  disorder.  But  we 
are  not  likely  to  realize  that  whenever  these  de- 
fects start,  they  are  always  likely  to  become  per- 
manent. It  is  the  idea  and  fear  of  this  perma- 
nency that  I  wish  to  instill. 

I  need  scarcely  mention  the  opinion  of  some 
persons  that  a  permanent  speech  disorder  may 
be  an  "ornament."  A  lisp  can  no  more  be  an 
"ornament"  than  any  other  defect,  such  as  a 
twisted  finger,  a  skin  birthmark,  or  a  crippled 
foot.  Yet  I  know  of  one  individual,  an  author, 
who  considers  that  her  lisp  is  worth  retaining  as 
a  personal  ornament.  She  would  not  remove  the 
defect  under  any  circumstances.  Of  course,  such 
individuals  are  outside  of  our  consideration.  We 
can  only  trust  that  they  will  outgrow  their  stand- 
ards of  taste  when  they  come  to  realize  the 
greater  pleasure  and  the  greater  excellences  to 
be  derived  from  exact  and  perfect  speech. 

Bad  as  a  permanent  speech  defect  may  be  in 
itself,  it  is  still  more  serious  in  its  effect  upon 
the  life  of  the  sufferer.  As  long  as  it  persists,  it 
deprives  him  of  much  of  that  success  in  life 
which  he  might  otherwise  attain.  For  example, 
entrance  upon  some  kinds  of  business  is  abso- 

5 


SPEECH  DEFECTS  IN  CHILDREN 

lutely  impossible  as  long  as  the  permanent  de- 
fect lasts.  As  we  come  more  definitely  upon  this 
subject  of  the  relation  of  the  speech  defect  to 
the  individual  we  shall  see  more  definitely  how 
speech  defect  deprives  one  of  advantages. 

J.  Defective  speech  marks  the  inefficient  worker 
Efficiency  is  the  order  of  the  day.  The  ad- 
vice of  efficiency  experts  is  being  considered  in 
the  management  of  all  sorts  of  business.  Now, 
the  man  with  speech  disorder  falls  most  assur- 
edly into  the  class  of  inefficient  workers.  He 
cannot  deal  clearly,  quickly,  and  adequately  with 
the  people  with  whom  he  comes  in  contact.  His 
faulty  speech  makes  it  impossible  for  him  to  ex- 
ternalize his  own  conceptions  so  as  to  satisfy 
those  whom  he  serves. 

One  or  two  practical  illustrations  of  inefficiency 
may  be  cited  here  to  show  how  greatly  speech 
disorders  affect  one's  efficiency,  to  show  the  ne- 
cessity of  their  elimination,  and  to  show  how  this 
elimination  opens  up  fields  of  opportunity  hardly 
thought  of  before. 

Let  us  first  look  at  some  of  the  fields  of  work 
where  permanent  speech  disorder  precludes  suc- 
cess. The  mere  mention  of  these  will  be  enough 
to  show  us  that  an  individual  is  debarred  from 

6 


GOOD  HABITS  OF  SPEECH 

them  by  speech  disorder.  For  example,  take  the 
ministry.  The  stutterer  cannot  possibly  succeed 
in  this  field.  The  person  who  has  a  few  speech 
defects,  a  foreign  pronunciation  of  vowels,  or  a 
foreign  accent,  becomes  a  burden  to  his  hearers. 
Again,  the  clerk  in  a  store  must  not  only  have  a 
pleasant  manner  and  good  command  of  English 
grammar,  but  she  must  have  a  standard  of  speech 
utterance  that  attracts  no  attention  to  itself.  Then 
there  are  almost  innumerable  other  situations 
where  ah  easy  flow  of  speech  free  from  disorder 
is  almost  the  first  requisite. 

All  this  leads  us  naturally  to  the  conclusion 
that  speech  disorder  in  the  adult  results  in  an 
absolute  exclusion  from  numerous  fields  of  work, 
study,  and  business,  or,  at  least,  renders  him  ab- 
solutely inefficient  if  he  tries  to  enter  them.  This 
indicates  that  the  same  defects,  even  where  they 
do  not  show  so  clearly,  make  for  inefficiency  just 
as  certainly. 

The  sufferer  with  speech  disorder,  then,  is  an 
inefficient  worker.  He  is  a  burden  to  society  and 
a  hedger  who  seeks  to  do  that  work  in  the  world 
in  which  his  defect  and  disorder  will  count  least 
against  him  or  will  show  up  least  clearly  in  his 
dealings  with  his  fellows. 

In  a  time  when  we  are  striving  to  uproot  in- 

7 


SPEECH  DEFECTS  IN  CHILDREN 

efficiency  in  all  its  forms,  striving  to  bring  every 
individual  to  the  maximum  of  his  powers,  should 
we  not,  then,  give  close  and  special  attention  to 
this  matter  of  speech  disorder?  We  have  seen 
that  it  is  hard  to  eradicate,  but  we  have  also  seen 
that  unless  it  is  attacked  in  time  there  is  grave 
danger  of  its  becoming  so  ingrained  as  to  be 
scarcely  susceptible  of  cure.  Once  it  has  become 
fixed  and  ingrained,  moreover,  it  is  a  most  serious 
deterrent  to  success  in  any  walk  of  life.  These 
considerations  make  it  clear  that  the  correction 
of  defects  in  speech  while  there  is  yet  time  should 
constitute  one  of  the  important  branches  of  edu- 
cation. 

^.  Social  success  dependent  upon  speech 

The  social  success  which  I  have  in  mind  at 
present  is  not  that  which  is  sought  by  men  and 
women  of  the  beau  monde^  it  does  not  depend 
upon  one's  wealth  or  the  number  of  his  acquaint- 
ances, it  has  no  connection  with  Vanity  Fair.  I 
speak  only  of  that  social  success  which  is  shown 
by  one's  ability  to  mingle  easily  and  freely  with 
other  people  in  any  walk  of  life  in  which  the 
social  relation  is  demanded. 

We  know  that  our  apparel  should  not  attract 
attention ;  we  know  that  our  deportment  should 

8 


GOOD  HABITS  OF  SPEECH 

be  free  from  eccentricity.  We  should  maintain 
this  same  quiet  and  unassuming  excellence  in  our 
usual  conversation,  in  our  habitual  utterances,  in 
our  modes  of  conversational  communication.  We 
should  cultivate  an  easy  and  natural  flow  of  utter- 
ance that  accomplishes  its  purpose  without  in  any 
way  calling  attention  to  itself.  Those  with  marked 
speech  disorder  cannot  attain  this  conversational 
excellence.  Some  of  the  worst  forms  of  speech 
disorders,  indeed,  cut  one  off  from  all  social  inter- 
course whatsoever. 

5.  Bad  habits  of  speech  impede  education 

One  of  the  most  obvious,  far-reaching,  and  seri- 
ous results  of  speech  defect  among  young  people 
is  the  interference  which  it  causes  in  their  edu- 
cation. Expert  examiners  commonly  find  that 
children  with  defective  speech  fail  to  keep  pace 
with  other  pupils  in  their  own  grades  where  they 
are  under  teachers  who  are  ignorant  of  how  to 
eliminate  that  defect.  It  is  less  common  but  vastly 
more  important  that  pupils  with  speech  disorder 
fail  of  promotion.  Pupils  that  have  brought  all 
the  rest  of  their  school  requirements  up  to  the 
standard  that  would  warrant  promotion  are  kept 
from  promotion  by  some  marked  speech  disorder 
and  by  this  alone.   There  are  more  numerous 

9 


SPEECH  DEFECTS  IN  CHILDREN 

cases  of  this  sort  than  we  have  any  idea  of.  This 
is  not  the  place  to  discuss  the  question  whether 
such  pupils  should  be  promoted  or  whether  they 
should  be  kept  back.  I  merely  want  to  call  atten- 
tion to  the  facts  as  an  illustration  of  the  way  in 
which  speech  disorder  impedes  education. 

There  are  still  worse  cases  than  this.  I  have 
in  mind  a  stutterer  who  became  so  nervous  from 
his  speech  defect  that  even  his  physician  wanted 
him  removed  from  school.  There  was  no  treat- 
ment undertaken  in  this  case.  In  fact,  no  effort 
was  made  to  relieve  him  of  his  difficulty.  His 
education  was  not  merely  impeded,  it  was  stopped 
altogether.  Such  cases  are  not  numerous,  but 
they  are  numerous  enough  to  afford  another  illus- 
tration of  the  importance  of  our  subject.  We 
even  find  numerous  children  whose  defective 
enunciation  or  total  lack  of  speech  does  not  hin- 
der or  impede  their  education,  but  prevents  it  at 
the  very  start. 

The  teacher  is  not  to  blame  for  the  impeding 
of  education  by  speech  disorders  if  the  superin- 
tendent's system  provides  no  means  of  training 
her  in  the  elimination  of  them.  Surely  she  can- 
not be  blamed  for  failing  to  promote  defective 
children.  The  defect  itself  prevents  her  from 
getting  the  proper  evidence  needed  for  promo- 

lO 


GOOD  HABITS   OF   SPEECH 

tion.  But  when  there  is  a  retardation  of  two  or 
three  years,  it  is  time  for  her  to  look  about  and 
see  if  the  trouble  is  not  eradicable. 

There  are  usually  deep-lying  causes  of  speech 
defect  which  elude  ordinary  observation.  We  are 
too  apt  to  think  of  speech  defect  as  a  matter  of 
mouth  utterance  only.  We  pay  too  exclusive  at- 
tention to  the  mere  speech  product.  There  is 
very  much  more  than  this  to  the  speech  mechan- 
ism, and  the  causes  of  speech  disorders  often  lie 
back  in  the  mental  processes  of  intake.  A  fre- 
quent cause  of  speech  defect  is  found  in  the  suf- 
ferer's inability  to  hear  properly.  It  is  clear  that 
faulty  hearing  would  make  it  difficult  to  repro- 
duce properly  the  sounds  of  speech.  Speech  de- 
fect is  not  usually  a  matter  of  enunciation  alone. 
It  usually  includes  a  defect  on  the  sensory  side 
or  an  inability  to  interpret  sensory  registrations 
in  a  reliable  way.  The  faulty  product  comes  from 
lack  in  sensory  control. 

Defective  utterance  is  really  a  very  small  part 
of  the  whole  problem ;  it  is,  in  fact,  hardly  a  part 
of  the  problem  at  all.  In  a  larger  sense  it  may  be 
called  only  a  symptom  of  the  problem.  This  is  be- 
cause, as  we  have  just  seen,  the  external  speech 
defect  may  be  interpreted  as  a  mere  sign  or  symp- 
tom of  a  deeper  defect  on  the  sensory  side  of  the 

II 


SPEECH  DEFECTS  IN  CHILDREN 

speech  mechanism,  the  mental  intake  side,  in 
some  complex  or  in  the  interpretative  or  thinking 
side ;  and  merely  in  consequence  of  this  deeper 
defect  do  we  have  the  faulty  vocal  output,  the 
inability  to  externalize,  the  mistakes  of  utterance, 
and  the  permanent  speech  defect. 


II 


METHODS  OF  CORRECTING  DEFECTS  OF 
SPEECH 

After  this  discussion  of  the  constant  and  crying 
need  for  correction  of  speech  disorders  in  pubUc 
schools,  —  a  need  which  in  many  places  is  not 
noticed  and  in  other  places  is  not  met,  — we  come 
naturally  to  the  consideration  of  methods  of  eradi- 
cating these  defects. 

The  methods  and  systems  of  cure  should  be 
uniform,  scientific,  and  based  upon  a  sound  psy- 
chology. Members  of  the  medical  profession 
who  have  gone  out  from  Boston  clinics  to  es- 
tablish centers  of  instruction  elsewhere  in  the 
country  are  doing  much  to  standardize  treatment, 
but  unfortunately  elsewhere  there  is  still  little 
general  agreement.  The  methods  of  eradication 
which  are  taught — particularly  in  the  institu- 
tions of  higher  learning  —  are  still  numerous  and 
varied. 

It  will  be  well  to  begin  with  a  brief  but  careful 
consideration  of  some  ways  of  approaching  the 
problem. 

13 


SPEECH  DEFECTS  IN  CHILDREN 

/.  Some  gejieral  methods — dividing  classes 

In  general,  the  speech-disorder  problem  re- 
solves itself  into  an  attempt  to  raise  the  faulty 
into  the  normal  voice,  to  eradicate  speech  defect 
and  replace  it  by  normal  speech.  One  reason  why 
so  many  of  the  weaker  efforts  made  in  this  line 
result  in  only  partial  eradication  lies  in  the  fact 
that  speech  as  a  whole  has  not  been  understood. 
It  is  very  important  in  studying  methods  to  have 
a  large  idea  of  the  field.  I  mean  by  this  that  we 
should  abandon  the  usual  narrow  interpretation 
of  speech  defects  and  learn  to  view  the  speech 
mechanism  scientifically  and  as  a  whole  embracing 
the  nervous  system  in  both  its  physiological  and 
its  psychological  aspects.  In  this  view  the  mouth, 
which  is  usually  the  only  factor  considered,  be- 
comes merely  a  part  of  the  external  speech  mech- 
anism :  lungs,  throat,  vocal  cords,  mouth,  nasal 
cavities,  and  the  intricate  system  of  muscles  that 
control  these  parts.  Outside  of  this  we  have  much 
more :  a  sensory  nervous  system  and  a  low  brain 
sensory  registration  area,  a  higher  brain  interpre- 
tation area,  and  intricate  collaborative  functions. 
On  the  motor  side  we  have  a  high  motor-control 
area,  a  low  motor-output  area,  which  includes  the 
nerves  that  go  down  to  supply  nervous  control  to 

14 


CORRECTING  DEFECTS  OF  SPEECH 

the  numerous  external  parts  of  the  speech  mech- 
anism. All  this,  then,  is  the  field  of  approach,  all 
this  is  our  field  of  study,  all  this  is  the  ground- 
work upon  which  we  are  to  build  perfected  speech, 
and  no  one,  without  a  thorough  understanding 
of  all  these  things,  can  expect  to  do  very  much 
with  the  speech  mechanism.  These  considerations 
show  the  extent  of  the  ground  upon  which  our 
efforts  are  to  be  directed. 

A  few  general  ideas  of  method  should  be  firmly 
fixed  in  the  teacher's  mind  and  should  pervade 
all  her  efforts  and  undertakings  in  the  details  ot 
treatment.  The  first  of  these  general  ideas  is  that 
of  the  great  importance  of  persistent,  long-con- 
tinued drill.  My  two  clinics  in  Boston  illustrate 
some  very  remarkable  cases  of  improvement.  The 
secret  of  this  improvement  lies  more  in  the  per- 
sistent and  long-continued  drill  gone  through  in 
these  cases  than  in  any  other  one  thing.  We  often 
think  that  the  mere  placement  of  an  external 
speech  part  where  it  ought  to  be  is  enough,  but 
those  who  are  experienced  in  this  line  of  work 
have  found  that  very  long  persistent  drill  is  the 
only  means  of  attaining  permanent  results. 

The  patient  should  be  held  to  the  exact  follow- 
ing of  exact  instructions.  He  should  not  be  al- 
lowed to  lapse,  to  practice  wrongly,  or  to  practice 

15 


SPEECH  DEFECTS  IN  CHILDREN 

in  a  slovenly  way.  He  should  be  constantly  made 
to  do  his  best. 

It  goes  almost  without  saying  that  special  at- 
tention must  be  given  throughout  the  period  of 
training  to  matters  of  hygiene.  The  aim  should 
be  to  secure  proper  rest,  exercise,  and  nutrition, 
so  that  the  attainment  of  new  vocal  habits  may 
progress  as  rapidly  as  possible. 

Special  attention  must  be  given  also  to  the 
proper  division  of  classes.  Speech  defects  differ 
in  their  characteristics,  in  the  time  necessary  for 
eradication,  and  in  their  nervous  or  psychological 
background.  They  natually  fall  into  the  follow- 
ing three  large  divisions  :  stuttering,  phonetic 
defect,  and  the  speech  of  mental  defectives. 

2.  Modem  treatment  of  stutterijig 

In  speaking  of  the  mode^m  treatment  of  stut- 
tering, I  refer  to  that  one  which  has  been  found, 
after  numerous  trials,  to  be  the  best  in  its  final 
results.  It  not  only  eliminates  the  trouble  itself 
in  a  majority  of  cases,  but  it  develops  the  men- 
tality of  the  patient  at  the  same  time  and  leaves 
him  with  a  more  rounded  personality  than  other 
methods  even  pretend  to  give.  As  far  as  I  know, 
no  other  method  makes  any  effort  to  apply  devel- 
opmental psychology.    Other  methods  partly  re- 

i6 


CORRECTING  DEFECTS  OF  SPEECH 

lieve,  sometimes  wholly  relieve,  the  stuttering 
itself,  but  they  never  give  the  patient  a  larger 
mental  horizon,  they  never  try  to  send  him  out 
a  larger  personality,  they  never  make  an  attempt 
to  broaden,  deepen,  and  widen  his  visualization 
processes.  When  a  method  can  not  only  cure 
stuttering,  but  can  also  develop  personality,  it  has 
claims  which  no  other  method  can  put  forward. 

Before  presenting  the  modern  method  of  treat- 
ment, it  will  be  well  to  say  a  word  about  some  of 
the  old  methods  in  order  to  show  the  contrast  in 
procedure  and  in  point  of  view.  The  oldest  form 
of  treatment  of  which  I  know  was  that  in  which 
the  physician  attempted  to  cure  the  stutterer  by 
the  amputation  of  a  part  of  the  tongue.  This  was 
placing  the  diagnosis  in  the  external  speech  mech- 
anism. After  this  the  diagnosis  was  placed  in 
numerous  parts  of  the  nervous  mechanism  on  the 
sensory-motor  side.  Not  long  ago  some  of  the 
lesser  lights  in  the  Freudian  constellation  placed 
the  diagnosis  in  the  subconscious  mentality. 

After  I  had  made  a  study  of  this  situation,  the 
only  unexplored  field  seemed  to  me  to  be  that 
of  the  conscious  mentality.  I  therefore  began  a 
series  of  researches  with  the  attempt  to  discover 
something  constant  behind  the  stuttering  in  the 
conscious  mental  make-up,  and  it  is  upon  discov* 

17 


SPEECH  DEFECTS  IN  CHILDREN 

eries  made  in  the  voice  clinic  of  the  Psychopathic 
Hospital  in  Boston  that  the  modern  treatment  is 
based.    Let  us  turn  now  to  that. 

Several  normal  individuals  were  tested  with  a 
list  of  some  fifteen  hundred  questions  to  ascertain 
the  conscious  content  of  their  minds  during  ut- 
terance. This  conscious  content  was  found  to  be 
a  visual  image.  Then  a  similar  series  of  stutter- 
ers was  put  through  the  same  experiment  and  it 
was  found  that  they  constantly  lacked  this  visual 
image  while  they  were  stuttering.  Upon  this  re- 
search finding  is  based  our  treatment,  which,  in 
a  word,  consists  in  very  gradually  developing  first 
meager  and  then  larger  and  then  very  extensive 
visualization  processes  over  the  speech  of  the 
stutterer  and  so  giving  him  that  apparently  es- 
sential faculty  which  is  found  constantly  present 
over  the  speech  of  the  normal  individual. 

From  this  general  idea  as  to  the  foundations 
of  the  modern  treatment,  let  us  pass  to  the  steps 
used  in  initiating  this  treatment.  We  begin  with 
a  series  of  breathing  exercises.  These  are  in- 
tended to  instill  control  of  the  breath  and  to  de- 
velop concentration.  After  this,  the  patient  is 
asked  to  hold  the  voice  on  a  single  musical  note 
or  tone  during  the  prolonged  expulsion  of  the 
breath.  Then,  in  addition  to  holding  this  note,  he 

i8 


CORRECTING  DEFECTS  OF  SPEECH 

is  asked  to  pronounce  a  word.  After  this,  he  is 
asked  to  hold  the  single  note  through  the  pro- 
nunciation of  a  sentence  and  of  a  stanza.  This 
method  is  continued  until  the  patient  has  devel- 
oped sufficient  concentration  to  hold  the  single 
note  over  quite  long  sentences.  We  next  explain 
that  the  holding  of  the  note  with  the  voice  is 
only  an  exercise  in  developing  the  power  of  con- 
centration and  nothing  more  than  an  introduction 
to  the  really  important  process  —  that  of  hold- 
ing a  visual  image  in  the  mind  during  utterance. 
After  this  has  been  explained  and  we  think  the 
patient  has  developed  enough  concentration  to 
warrant  our  passing  on  to  the  exercise  of  the 
mental  image,  we  begin  with  single  words  and 
proceed  gradually  to  the  use  of  short  sentences, 
}ong  sentences,  verse  and  prose,  short  original 
stories,  and  long  pieces  of  dramatic  literature, 
until  we  have  developed  elaborate  visualization 
processes  to  the  more  or  less  complete  elimina- 
tion of  the  stuttering  habit.  Uninterrupted  sug- 
gestion accompanies  these  steps. 

With  this  brief  statement  of  the  method 
which  is  employed,  let  us  turn  to  the  detailed 
exercises  that  are  given  in  series  from  the  begin- 
ning to  the  end  of  the  treatment.  The  object  of 
most  of  these  exercises  is  to  draw  the  attention 

19 


SPEECH  DEFECTS  IN  CHILDREN 

from  the  words  to  be  pronounced  toward  the 
notes  held  in  mind  and  afterwards  to  the  visual 
pictures. 

Exercises 

Position,  Correct  standing  position,  heels  to- 
gether, chest  up,  chin  in,  body  straight,  hands  to 
the  sides. 

Exercise  /.  Take  a  deep  breath  slowly  and  ex- 
hale as  slowly  as  possible.  The  inhalation  and 
exhalation  should  be  through  the  nose.  At  the 
same  time  the  arms  are  raised  during  inhalation 
till  the  hands  touch  over  the  head  and  lowered 
slowly  during  exhalation. 

Exercise  2.  Same  as  Exercise  i,  but  on  exha- 
lation sound  the  syllable  "Ma,"  keeping  it  of 
even  volume  and  intensity  and  prolonging  the 
utterance  as  much  as  possible. 

Exercise  J.  This  is  the  same  as  Exercise  2,  but 
instead  of  prolonging  the  "Ma"  on  an  even 
pitch  sing  the  scale  with  "Ma." 

Exercise  4,  Same  as  Exercise  3,  except  that 
"Ma"  is  sounded  on  low  C,  high  C,  and  low  C 
again  prolonged  as  before. 

Exercise ^.  The  w^ord  "Mother"  is  now  ut- 
tered. The  voice  is  made  to  move  up  and  down 
the  octaveat  about  the  speed  of  normal  conver- 

20 


CORRECTING  DEFECTS  OF  SPEECH 

sation.  This  ends  the  introductory  exercises.  The 
purpose  of  all  these  is  to  concentrate  the  atten- 
tion on  a  mental  note. 

Word  exercise.  The  patient  is  asked  to  apply 
this  octave  exercise  to  every  word  of  the  follow- 
ing stanza : 

"Mary  had  a  little  lamb, 
Its  feet  were  white  as  snow, 
And  everywhere  that  Mary  went, 
The  lamb  was  sure  to  go." 

Line  exercise.  When  the  patient  has  learned 
to  execute  this  bit  of  vocal  drill  with  fluency  and 
ease,  I  teach  him  to  jump  the  octave  on  the  first 
word  in  the  line,  and  then  to  let  the  voice  run 
down  the  octave  through  all  the  succeeding 
words  of  that  line  until  the  note  from  which  he 
started  is  reached.  The  stanza  used  in  this  exer- 
cise is  as  follows : 

"Twinkle,  twinkle,  little  star. 
How  I  wonder  what  you  are! 
Up  above  the  world  so  high, 
Like  a  diamond  in  the  sky." 

Following  this,  I  teach  him  to  rise  through 
the  octave  from  the  beginning  to  the  middle  of 
the  line  and  then  to  let  the  voice  fall  gradually 
to  the  end  of  the  line.  The  words  on  which  the 
high  note   is  struck  are  "glorious,"  "grass," 

21 


SPEECH  DEFECTS  IN  CHILDREN 

"  shine,"  and  "  twinkle."  For  this  exercise  I  use 
the  verse : 

"When  the  glorious  sun  is  set 
And  the  grass  with  dew  is  wet, 
Then  you  shine  your  httle  Hght, 
Twinkle,  twinkle  all  the  night." 

I  usually  follow  this  by  having  the  patient  tell 
stories  with  a  vocal  execution  like  that  used  in  the 
three  last  exercises.  He  first  tells  a  story  in  short 
sentences,  the  pitch  of  the  voice  rising  and  falhng 
with  every  word  until  the  end  of  the  sentence  is 
reached.  In  the  next  story  his  voice  is  to  leap 
the  octave  on  the  first  word  of  the  sentence  and 
to  decline  on  the  rest.  Finally,  he  tells  a  stor) 
with  the  voice  taking  the  octave  jump  on  some 
important  or  easily  emphasized  word  near  the  be- 
ginning of  each  sentence  and  then  declining  on 
the  following  words.  This  series  of  exercises  with 
short  sentences  might  be  followed  by  a  similar 
series  dealing  with  stories  in  longer  sentences. 
This  sort  of  exercise  is  kept  up  until  the  patient 
has  acquired  fluency  and  ease  in  applying  it  to  any 
new  thing  that  he  tries  to  learn,  say,  or  repeat. 
The  process  is  suggestive. 

This  drill  really  marks  and  ends  the  introduc- 
tory phase  of  the  treatment,  and  after  there  is 
sufficient  concentration  developed  to  hold  this 

22 


CORRECTING  DEFECTS  OF  SPEECH 

note  and  apply  it  consistently  on  all  sorts  of  ma- 
terial, I  start  the  patient  on  the  processes  of  vis- 
ualization. First,  I  ask  him  to  take  some  single 
word  and  utter  it  with  the  visual  image  naturally 
called  up  by  that  word  distinctly  in  mind.  Then 
he  does  the  same  thing  in  pronouncing  a  sen- 
tence, verses,  prose,  original  stories.  By  these 
stages  he  gradually  develops  until  he  can  render 
some  pretty  complicated  dram.atic  pieces. 

This  description  of  the  method  is  almost 
enough  to  enable  one  to  start  in  and  carry  it  out, 
but  for  fear  that  some  may  need  to  have  a  series 
of  exercises  put  down,  I  will  give  a  series  which 
I  have  used  in  my  own  practice. 

The  first  selection  for  visualizing  is  usually  the 
word  "builders."  I  try  to  secure  in  the  minds  of 
my  patients  as  clear  and  fine  a  picture  of  build- 
ers as  possible,  and  I  let  this  stand  as  the  exam- 
ple and  ideal  for  visualization  processes  in  the 
work  that  follows.  Next  I  turn  to  a  sentence. 

"Under  the  spreading  chestnut-tree 
The  village  smithy  stands; 
The  smith,  a  mighty  man  is  he, 
With  large  and  sinewy  hands,"  — 

is  a  very  good  verse  for  a  wider  and  more  diflfi- 
cult  application  of  a  visual  image  exercise.  I 
train  the  patient  to  see  the  tree  in  his  mind's  eye 

23 


SPEECH  DEFECTS  IN  CHILDREN 

before  he  begins  to  pronounce  the  word  "  tree," 
to  hold  that  tree  in  mind  while  he  is  saying  the 
word,  and,  when  he  comes  to  the  description  of 
the  blacksmith,  to  replace  the  picture  of  the  tree 
by  ?..  picture  of  the  smith  standing  at  his  forge 
under  the  tree. 

«*  The  Chambered  Nautilus  "  is  another  good 
verse  to  practice  on,  as  it  is  pretty  thickly  studded 
with  numerous  and  quickly  changing  visual  pic- 
tures. 

The  "Witch  Scene"  in  Macbeth  is  another 
good  piece  that  may  be  used  here.  It  runs  as 
follows : 

1.  Witch.  Where  shall  we  three  meet  again? 
In  thunder,  lightning,  or  in  rain? 

2.  Witch.  When  the  hurlyburly's  done, 
When  the  battle 's  lost  and  won. 

J.  Witch.  That  -will  be  ere  the  set  of  sun. 
J.  Witch.  Where  the  place? 
2.  Witch.  Upon  the  heath. 
J.  Witch.  There  to  meet  with  Macbeth. 
J.  Witch.  I  come,  Graymalkin! 
2.  Witch.  Paddock  calls;  Anon! 
All.  Fair  is  foul,  and  foul  is  fair, 
Hover  through  the  fog  and  filthy  air!  {JB^xcwni^ 

After  these  one  may  feel  at  Hberty  to  choose 
whatever  extracts  from  literature  seem  desirable. 
One  of  the  best  ones  of  which  I  know  is  the 
**  Dagger  Scene  "  from  Macbeth,  and  another  ont 

.  24 


CORRECTING  DEFECTS  OF  SPEECH 

is  the  "  Mad  Scene  "  in  the  same  play.  Sugges- 
tion dominates  the  whole  process. 

The  modern  method  of  treatment  for  stutter- 
ing has  been  clearly  outlined  above,  but  I  can 
conceive  that  some  who  misunderstand  the  back- 
ground of  this  method  might  apply  the  exercises 
without  reaching  the  results.  I  therefore  advise 
some  little  experience  in  applying  this  method  in 
the  clinic  or  some  observation  of  the  process  as 
practiced  either  in  the  clinics  in  Boston  or  under 
some  of  the  numerous  teachers  who  have  gradu- 
ated from  the  Boston  courses  and  become  centers 
of  instruction  in  other  parts  of  the  country.  I  do 
not  advise  this  because  the  method  is  particu- 
larly difficult.  I  think  it  is  no  more  difficult  than 
the  proper  teaching  of  reading  in  the  schools. 
Teachers  are  not  allowed  to  give  instruction  in 
reading,  however,  unless  they  have  passed  a  nor 
mal  course  in  the  subject.  Therefore  I  should 
most  seriously  recommend  at  least  a  little  "  try- 
ing it  on  the  dog  "  before  the  method  is  tried  on 
the  pupil. 

Now  for  the  school  application  of  this  method 
of  treating  stuttering.  I  might  say  that  the  whole 
class  for  stutterers  should  be  put  through  in  uni- 
son, perhaps  as  far  as  the  second  stanza,  of 
"Twinkle,  twinkle,  little  star!"  starting  at  the 

25 


SPEECH  DEFECTS  IN  CHILDREN 

beginning  of  the  year  with  only  one  or  two  exer- 
cises and  adding  one  or  two  a  week.  It  takes 
from  two  to  three  months  to  get  through  this 
second  stanza.  When  the  class  can  do  any  given 
exercise  well  in  unison,  I  would  spend  the  rest 
of  the  study  period  with  individual  treatment,  giv- 
ing each  what  his  own  individual  case  seems  to 
demand. 

J.   Treatment  of  phonetic  defects 

Phonetic  defects  are  departures  from  the  local 
standard  of  the  sounds  of  vowels  and  consonants. 
They  are  as  numerous  as  are  the  phonetic  utter- 
ances included  in  our  language,  multiplied  by 
about  ten  or  more  to  cover  the  different  forms 
in  which  the  defects  appear.  Some  systems  study 
minutely  the  form  of  the  individual  defect  and 
try  gradually  to  get  the  patient  out  of  it.  Others 
try  to  instill  the  correct  mouth  positions  at  once, 
with  no  other  sort  of  exercises  whatever.  The 
best  method  differs  somewhat  from  these,  and  is 
really  a  larger  and  more  fundamental  attack  upon 
the  whole  process  of  phonetic  utterance  than  any 
of  these  above  processes  can  ever  possibly  pre- 
tend to  be. 

The  method  of  phonetic  correction  may  be 
considered  under  four  large  divisions:  (i)  Mus- 

26 


CORRECTING  DEFECTS  OF  SPEECH 

cular  development ;  (2)  ear  sensitiveness ;  (3) 
form  of  motor  output ;  (4)  position  of  motor 
output.  I  mean  by  these,  briefly,  as  follows ; 

Muscular  development  as  a  basis  for  phonetic 
excellence  is  brought  about  by  a  systematic  drill 
of  all  the  muscles  of  the  jaw,  mouth,  tongue,  and 
throat.  The  purpose  of  this  drill  is  to  increase 
muscular  control  and  thereby  to  increase  the  pa- 
tient's ability  to  make  exact  and  minute  vocal 
coordinations.  I  consider  this  the  most  valuable 
of  all  possible  foundations  for  the  development 
of  correct  phonetic  utterance. 

The  development  of  ear  sensitiveness  enables 
the  patient  to  differentiate  accurately  one  sound 
from  another,  and  also  to  differentiate  between 
sound  forms  such  as  pitch,  intensity,  and  other 
factors  in  vocal  utterance.  I  hold  that  defects  in 
phonetic  output  may  have  their  seat  in  defective 
phonetic  intake.  Sounds  ill-heard  are  likely  to  be 
ill-pronounced.  When  intake  is  perfected,  it  pro- 
vides a  good  basis  for  the  perfection  of  output. 

By  the  phrase,  form  of  motor  output y  I  refer  to 
the  idea  of  an  acoustic  form  which  may  be  held 
in  mind  without  utterance  of  the  sound  to  which 
it  corresponds. 

I  consider  that  concentration  upon  the  sensory 
ear  intake,  and  the   development  of  that  con- 

27 


SPEECH  DEFECTS  IN  CHILDREN 

centration  into  the  ability  to  hold  the  form  of  a 
sound  foi  motor  output,  offer  excellent  training 
in  the  development  of  final  phonetic  excellences. 
Under  the  heading,  position  of  motor  output^  I 
teach  the  exact  coordination  and  position  of  ex- 
ternal vocal  agents  —  tongue,  jaw,  teeth,  lips, 
and  throat  —  in  the  execution  of  a  sound  held  in 
mind.  Exercise  in  exact  coordinations  of  motor 
output  and  in  ability  to  hold  these  in  the  mind 
and  to  correlate  them  with  the  form  of  the  acous- 
tic idea  is  an  essential  process  at  the  very  foun- 
dation of  all  good  speech  instruction.  We  must 
acoustically  experience  good  speech,  to  have  it, 

4.  Management  of  the  special  class 

The  author  was  the  first  to  formulate  a  pro- 
gram for  a  speech  survey  among  special  classes 
for  the  retarded,  and  to  follow  this  by  the  com- 
pilation of  a  course  of  lectures,  attacking  the 
speech  problem  among  mental  defectives,  illus- 
trating the  successful  and  in  many  cases  marvel- 
ous results  that  have  come  from  a  special  vocal 
drill  applied  to  pathological  minds  and  speech 
cases. 

The  great  mistake  commonly  made  in  treating 
the  speech  of  mental  defectives  has  lain  in  the 
application  to  them  of  methods  proper  only  to 

28 


CORRECTING  DEFECTS  OF  SPEECH 

the  treatment  of  normal  pupils.  We  place  these 
pathological  mentalities  in  classes  of  their  own, 
where  they  do  not  have  the  usual  educational 
curriculum  and  are  put  to  what  is  called  ''  indus- 
trial drill  "  —  a  vastly  inferior  method  of  educa- 
tion. Why,  then,  should  the  phonetics  used  in 
classes  where  minds  are  average  be  applied,  with 
any  expectation  of  valuable  results,  to  special 
classes  where  minds  are  in  many  ways  markedly 
inferior  ?  The  situation  is  ridiculous,  unscientific, 
unpsychological,  ill-advised,  —  a  work  of  the  igno- 
rant attempter. 

The  ideal  system  of  phonetics  for  pathological 
minds  is  one  that  differs  as  markedly  from  nor- 
mal phonetics  as  industrial  drill  does  from  the 
work  in  the  normal  grades.  In  other  words,  to 
reach  the  mental  defective,  we  should  take  at 
least  as  big  a  step  down  from  the  phonetics 
proper  to  normal  minds  as  we  do  in  passing  from 
normal  grade  work  to  industrial  drill.  This  is 
what  I  have  done  in  devising  a  new  system  for 
the  phonetic  training  of  the  mentally  deficient. 

The  mental  defective  is  first  put  through  a 
series  of  tests  to  see  how  much  he  can  utter.  I 
have  him  say  the  vowels,  thus  :  "  Ah,  a,  e,  aw,  o, 
00."  When  he  has  said  them  separately,  I  note 
how  many  he  can  say  in  series.  Then  I  have 

29 


SPEECH  DEFECTS  IN  CHILDREN 

him  practice  them,  first  those  that  he  can  say  in 
series,  for  ten  or  fifteen  minutes  three  to  five 
times  a  day,  for  one  week.  My  next  step  is  gov- 
erned by  the  advance  that  has  been  made  during 
the  first  week.  Sometimes  I  have  him  repeat  the 
first  exercise  for  another  week.  Sometimes,  when 
the  patient  was  originally  able  to  say  only  two 
vowels,  I  add  three  to  those  he  can  already  pro- 
nounce. Or  I  may  add  six  in  series,  when  he  has 
previously  been  able  to  say  three  in  series.  Then 
I  have  him  begin  with  some  consonant  that  he 
has  already  learned,  and  place  that  before  each 
vowel.  After  this  I  have  him  pass  through  sev- 
eral other  consonants  that  he  already  knows,  and 
have  him  place  each  before  each  vowel.  Then  I 
have  him  place  the  same  consonants  after  each 
vowel,  and  finally  before  and  after.  In  this  way 
I  give  him  about  one  new  vowel  or  vowel  com- 
bination a  week,  insist  upon  intensive,  constant, 
and  prolonged  drill,  and  then  continue  the  proc- 
ess, making  it  more  and  more  complicated  as  it 
ad\^nces.  If  these  exercises  are  carried  on  for 
two  or  three  months,  a  great  deal  of  improvement 
results.  With  these  I  have  known  a  mental  defec- 
tive in  eight  months  to  advance  two  years  on  his 
Binet  scale. 

I  go  on  to  familiar  words  after  this  and  then 

30 


CORRECTING  DEFECTS  OF  SPEECH 

to  very  short  sentences,  then  to  longer  sentences, 
and  finally  to  verse  and  prose,  with  the  instal- 
lation of  visualization  processes.  The  whole 
process  is  nothing  but  an  increasingly  complex 
arrangement  of  simple  phonetic  utterances.  Each 
step  in  the  process  is  minutely  adapted  to  the 
capacities  of  the  mental  defective.  It  is  not  sug- 
gestive therapeutics. 

5',  How  parents  can  kelp 

One  of  the  most  important  and  valuable  ad- 
juncts to  speech-improvement  classes  is  to  be 
found  in  cooperative  influence  of  the  family.  The 
parents  should  be  called  in  soon  after  their  child 
has  been  put  in  any  class  for  the  elimination  of 
speech  defects  and  should  be  given  a  careful  ex- 
planation of  the  dangers  threatening  the  child 
because  of  his  speech  disorder.  They  should  be 
shown  that  the  child  is  likely  to  be  kept  back 
in  the  grades  and  to  become  a  laughing-stock 
among  his  fellows  unless  his  defect  is  cured.  The 
strong  likelihood  that  this  defect,  unless  cured 
early  in  life,  will  become  a  permanent  handicap 
in  later  life,  resulting  in  retarded  education,  lack 
of  friends,  low  pay,  and  general  inefficiency,  should 
be  clearly  presented  to  them.  It  should  be  made 
clear  that  the  object  of  the  speech  teacher  and 

31 


SPEECH  DEFECTS  IN  CHILDREN 

of  the  assignment  of  the  child  to  a  speech-im- 
provement class  is  simply  that  these  dangers  may 
be  averted.  This  explanation  will  inspire  interest 
at  home,  will  induce  the  parents  to  see  that  drill 
and  practice  are  carried  out,  and  will  enable  them 
to  help  in  many  other  ways. 

I  should  also  call  the  parents  in  later  at  fre- 
quent intervals  so  that  they  may  observe  the 
child's  progress  and  report  upon  his  faithfulness 
in  practice  at  home.  At  the  same  time  they  may 
be  influenced  again  to  help  in  whatever  is  being 
done  for  their  child  in  the  class. 

More  than  in  any  other  way,  the  parents  can 
help  in  overseeing  the  hygienic  measures  neces- 
sary to  any  real  speech  improvement.  They  can 
see  to  it  that  the  child  does  not  play  too  hard  or 
too  much ;  they  can  see  that  he  gets  the  proper 
amount  of  sleep ;  they  can  maintain  a  diet  of 
normal  and  advised  standard  and  amount;  they 
can  look  after  the  clothing  and  the  baths,  and 
minimize  the  outside  work  that  some  children  are 
forced  into,  which  saps  their  vitality  to  such  an 
extent  that  no  good  work  in  phonetics  can  possi- 
bly be  done  with  them. 

Sometimes  progress  is  found  to  be  quite  im- 
possible unless  family  cooperation  —  the  sympathy 
and  good-will  of  the  parents — is  obtained  and 

32 


CORRECTING  DEFECTS  OF  SPEECH 

maintained  throughout  the  whole  period  of  treat- 
ment. This  matter  is  of  great  importance.  It 
may  make  all  the  difference  between  success  and 
failure. 

6.  Function  of  the  school  physician 

The  teacher  of  speech  disorder  should  endeavor 
to  elicit  the  interest  and  the  services  of  the  school 
physician.  The  aid  furnished  by  him  may  be  in- 
valuable to  the  teacher,  mostly  in  the  way  of 
eliminating  those  physical  causes  of  speech  dis- 
order which,  with  her  lay  training,  she  is  incapa- 
ble of  finding.  The  school  physician  can  tell  when 
a  tic — that  spasm  of  related  muscular  movements 
—  is  interfering  with  the  improvement  of  a  stut- 
terer. The  physician  can  tell  when  chorea  is  the 
main  cause  of  a  sudden  phonetic  slump.  He  can 
explain  the  incurableness  of  the  congenital  syphi- 
litic, as  well  as  the  permanent  and  unremovable 
defect  presented  in  a  juvenile  case  of  tabes.  Then 
he  can  discover  the  cases  of  speech  defect  due 
to  idiocy  and  imbecility,  and  can  save  the  teacher 
unsophisticated  in  medical  subjects  much  time 
and  effort  by  telling  her  that  in  those  cases  she 
need  not  expect  any  great  amount  of  improve- 
ment. It  is  in  this  diagnostic  service,  this  deeper, 
internal,  medical  interpretation  of  the  background 

S3 


SPEECH  DEFECTS  IN  CHILDREN 

of  speech  disorder,  that  the  school  physician 
can  give  the  teacher  invaluable  assistance.  The 
teacher  should  respect  his  diagnosis  and  follow  his 
medical  advice.  She  should  respect  the  diagnosis 
because  it  is  the  outcome  of  the  accumulated 
knowledge  of  the  medical  profession  and  is  really 
the  physician's  legitimate  and  exclusive  function. 
Much  of  her  success  in  managing  her  speech-im- 
provement class  depends  upon  her  ability  and 
tact  in  using  the  services  of  the  school  physician. 
While  the  physician  can  offer  knowledge,  diag- 
nosis, and  advice  in  medical  matters,  the  teacher 
should  realize  the  ignorance  of  the  ordinary 
physician  in  regard  to  such  special  work  as  her 
own.  He  may  advise  that  speech  defects  be  let 
alone,  so  that  they  may  be  **  outgrown."  He  may 
assert  that  they  really  amount  to  nothing.  He 
does  not  realize  the  relations  of  speech  disorder 
to  the  school  curriculum.  He  does  not  know  that 
the  speech  defective  is  also  a  singing  defective,  a 
writing  defective,  a  spelling  defective,  and  some- 
times even  a  mathematical  defective.  Far  less 
does  he  appreciate  the  fact  that  the  elimination 
of  speech  disorder  by  the  methods  indicated  in 
this  book  means  also,  to  a  very  large  extent,  the 
simultaneous  elimination  of  all  those  other  kinds 
of  defects  just  mentioned. 

34 


CORRECTING  DEFECTS  OF  SPEECH 

The  physician  may  be  able  to  explain  the  non- 
progress  of  medical  cases,  the  background  of 
which  he  has  diagnosed  and  in  which  he  has  found 
some  condition  that  makes  progress  impossible. 
This  may  excuse  the  teacher  for  apparent  failures 
in  regard  to  which  a  superintendent,  not  under- 
standing the  whole  field,  might  perhaps  blame 
the  teacher,  sometimes  with  a  serious  outcome. 
The  physician  can  also  relieve  the  teacher  from 
much  worry  and  anxiety  caused  by  the  non-prog- 
ress of  some  of  these  hopeless  cases.  The  physi- 
cian can,  in  an  authoritative  way,  advise  the  family 
to  carry  out  hygienic  measures  where  a  teacher 
cannot,  or  he  can  occasionally  remove  a  case  from 
the  speech  class  and  put  it  in  a  special  institution, 
a  hospital,  or  a  home  for  recovery. 

7.    What  the  superintendent  should  do 

The  superintendent's  office  should  contain 
some  one  sufficiently  interested  in  the  speech 
problem  in  public  schools  to  engineer  the  entire 
work.  He  should  be  the  general  supervisor  and 
manager  of  all  work  done  in  the  schools  of  his 
city  in  speech  improvement.  He  should  be  con- 
stantly bringing  new  ideas  from  the  outside  world 
and  inspiring  the  teachers  under  him  to  adopt 
them,  as  well  as  to  obtain  for  themselves,  in  the 

35 


SPEECH  DEFECTS  IN  CHILDREN 

proper  places,  advanced  instruction,  practice,  and 
knowledge. 

I  think  one  superintendent  or  assistant  alone 
should  be  relegated  to  this  work.  He  should  re- 
ceive regular  monthly  reports  of  the  progress 
made  in  every  individual  case  listed  in  the  speech- 
improvement  classes.  He  should  insist  upon 
regular,  complete,  and  scientific  records  of  every 
case  from  the  time  of  its  entrance  into  the  speech 
class.  The  entries  should  be  made  week  by  week 
and  month  by  month,  if  not  of  tener,  and  should 
be  sent  to  the  superintendent  as  monthly  reports. 
If  of  scientific  value,  they  may  well  be  used  by 
the  superintendent  or  by  the  teacher  in  the  forma- 
tion of  papers  to  be  read  to  societies  or  published, 
thus  giving  wider  scope  to  the  good  work  of  the 
individual  teacher.  This  will  lead  to  increase  of 
salary,  new  appointments,  and  wider  opportuni- 
ties for  growth  and  progress. 

The  speech  superintendent  should  acquaint 
himself  with  the  special  training  of  his  speech 
teachers.  He  should  understand  the  educational 
background  of  the  instructors  that  his  teachers 
have  had.  He  should  know  the  different  institu- 
tions— medical  schools,  clinics,  and  special  schools 
— where  speech  instruction  is  given.  This  knowl- 
edge will  enable  him  to  advise  his  present  and 

36 


CORRECTING  DEFECTS  OF  SPEECH 

future  teachers  intelligently  in  their  search  for 
further  training.  It  will  enable  him  to  give  them 
a  timely  warning  against  the  fakes,  charlatans, 
and  untrained  impostors  that  invade  this  field  all 
over  the  country.  All  of  these  should  be  care- 
fully tabulated  and  hung  up  in  the  Rogues'  Gal- 
lery of  his  mind  so  that  he  can  prevent  any  of 
his  teachers  from  thinking  that  they  have  scien- 
tific and  expert  training  in  the  field  of  speech 
when  they  have  merely  wasted  their  money  on 
pretenders. 

The  teacher  should  look  to  the  superintendent 
for  all  the  services  that  have  been  mentioned 
above.  She  should  take  to  him  cases  that  do  not 
progress.  She  should  go  to  him  about  the  removal 
of  feeble-minded  children  from  her  classes.  She 
should  go  to  him  for  the  solution  of  inexplicable 
backgrounds  in  cases  needing  the  services  of  the 
physician,  or  those  in  which  the  service  of  the 
school  doctor  has  been  inefficient,  inconclusive,  or 
vague.  Through  the  superintendent  the  teacher 
should  get  advice  about  the  speech  expert  to  be 
consulted  for  the  solution  of  her  more  puzzling 
problems. 

In  a  word,  then,  the  superintendent  is  the  final 
guiding  authority  and  the  final  resort  for  the 
teacher. 

37 


SPEECH  DEFECTS  IN  CHILDREN 

8.  Advice  from  the  Medical  expert  in  speech 

The  teacher  will  find  that  whereas  the  usual 
case  of  speech  disorder  improves  gradually  under 
treatment  until  finally  cured,  there  are  some  cases 
that  progress  at  first  fairly  well  and  then  stop ; 
there  are  other  cases  that  progress  only  a  little 
and  halt ;  there  are  a  few  that  show  from  the  start 
no  advance  whatever.  We  may  suppose  that  she 
has  taken  these  stubborn  cases  to  the  school  phy- 
sician, or  at  least  has  consulted  his  record  in  search 
of  some  solution.  She  has  put  the  case  before  the 
superintendent,  and  satisfactory  results  are  not 
forthcoming.  She  has  asked  the  other  teacher  or 
several  other  teachers,  and  they  are  all  puzzled. 
The  final  thing  to  do  is  to  call  in  the  services  of  a 
speech  expert  —  the  highly  trained  medical  man 
who  brings  to  every  case  not  only  a  general  edu- 
cation, a  medical  education,  and  experience  in  in- 
ternal medicine,  but  also  special  study  in  the  nerv- 
ous diseases,  neurology  and  psychiatry,  and  special 
study  of  the  throat.  He  should  have  also  a  wide 
knowledge  of  psychology  —  and  not  alone  that  to 
be  found  in  the  universities,  but  also  such  a  knowl- 
edge of  individual  psychology  as  is  to  be  found  in 
the  schools  of  dramatic  art.  Above  all  this  he 
should  have  had  training  under  the  speech  experts 

38 


CORRECTING  DEFECTS  OF  SPEECH 

of  Europe  and  America.  By  bringing  to  bear  a 
large  array  of  medical  knowledge  drawn  from 
numerous  fields  of  training,  and  focusing  all  his 
understanding  and  learning  upon  one  puzzling 
case,  such  a  man  can  often  solve  problems  at  once 
which  have  baffled  all  the  other  minds  that  have 
attacked  it. 

The  advice  of  the  medical  speech  expert  is 
based  upon  several  exhaustive  methods  of  inves- 
tigation. The  teacher,  therefore,  should  realize 
that  in  bringing  the  case  to  him  she  is  bringing 
it  in  line  with  medical  research,  is  putting  it  in 
touch  with  investigation,  is  putting  it  where  ex- 
haustive and  scientific  research  of  the  whole 
problem  may  be  carried  through. 

Advice  that  emanates  from  such  investigation 
can  be  of  great  value  to  the  teacher  in  solving 
her  problems,  in  changing  her  treatment,  in  elimi- 
nating incurable  cases  from  her  class,  in  excusing 
her  seeming  lack  of  success  before  the  superin- 
tendent. Sometimes  if  cases  are  brought  early 
enough  to  the  expert,  the  teacher  may  be  saved 
weeks  or  months  of  tedious  treatment  as  well  as 
undeserved  blame  from  her  superintendent,  the 
scorn  of  her  co-workers,  and  nights  of  worry  and 
anguish  for  fear  she  may  be  blamed. 


39 


SPEECH  DEFECTS  IN  CHILDREN 

p.  When  to  return  cases  to  the  regular  grades 

It  should,  of  course,  be  the  ideal  of  teachers 
conducting  special  classes  in  the  public  schools  to 
return  as  many  of  their  pupils  as  possible  to  the 
regular  grades.  This  ideal,  seldom  extensively 
realized  in  classes  for  mental  defectives,  is  entirely 
reasonable  in  the  case  of  classes  for  the  eradica- 
tion of  speech  defects  where  such  classes  are 
conducted  in  a  scientific  way  by  properly  equipped 
teachers. 

It  is  important  to  know,  therefore,  when  to 
make  this  return.  Should  the  case  be  sent  back 
when  improvement  has  begun }  Should  the  return 
be  made  when  the  defect  has  been  eliminated,  or 
should  the  case  remain  after  cure,  and,  if  so,  how 
long  ?  In  a  brief  treatise  it  is  almost  impossible 
to  give  exact  and  minute  advice  on  every  sort  of 
case  that  may  be  met  in  the  schools.  I  think  it 
will  be  well  to  devote  a  paragraph  to  each  of  the 
different  headings  under  which  the  speech-defect 
problem  has  been  discussed. 

The  members  of  the  phonetic  class  may  be  re- 
turned after  their  new  pronunciations  have  be- 
come easy,  automatic,  and  unconscious  in  every- 
day conversation  and  •  after  this  condition  has 
lasted  for  a  month.  I  should  not  even  then  have 

40 


CORRECTING  DEFECTS  OF  SPEECH 

them  cease  to  practice.  They  should  return  occa- 
sionally to  the  class  for  tests  and  further  advice 
— at  first  every  two  weeks,  and  then,  after  two 
or  three  months,  every  month  for  a  year.  In  some 
cases  this  will  be  unnecessary.  It  is  a  matter  of 
precaution.  I  warn  teachers  that  it  will  save  them 
much  criticism,  will  improve  their  results,  and 
will  bring  those  unusual  excellences  that  only 
persistent  drill  can  produce. 

Members  of  the  sttittering  class  should  be 
treated  in  a  similar  way,  but  they  should  be  re- 
leased more  gradually  and  should  be  watched 
afterwards  for  two  years  instead  of  one  year. 
Besides  this,  they  should  be  advised  to  return  at 
once  on  any  marked  relapse.  Not  only  should 
they  be  made  to  report  themselves,  but  they 
should  bring  reports  from  teachers  and  parents. 
Stuttering,  unlike  phonetic  defect,  is  intermit- 
tent, so  that  to  watch  it  thoroughly  one  must  have 
reports  from  different  sources  —  from  teacher, 
home,  and  even  playmates. 

The  members  of  the  class  for  menial  defectives 
are  usually  non-returnables  anyway.  Rarely  will 
one  be  sent  back  to  the  regular  grades,  and  they 
should  all  be  put  under  permanent  and  persistent 
vocal  drill  for  a  period  of  two  )^ears,  and  then 
watched  for  two  years  longer.  In  general,  indi- 

41 


SPEECH  DEFECTS  IN  CHILDREN 

vidual  cases  are  to  be  returned  on  their  individ- 
ual merits. 

10.    Value  of  records  on  all  cases 

I  have  frequently  mentioned  the  importance, 
nay,  the  absolute  necessity,  of  an  accurate  and 
regular  record.  It  is  time  to  deal  with  this  mat- 
ter in  more  detail,  to  state  clearly  what  a  record 
is,  how  it  should  be  started,  what  it  should  con- 
tain, and  what  services  it  should  render  to  the 
teacher,  to  the  doctor,  to  the  superintendent,  and, 
last  but  not  least,  to  the  case  in  hand. 

Speech-defect  records  should  begin  with  the 
statement  of  a  complaint.  This  may  be  a  term 
expressing  what  the  mother  complains  of,  or  a 
summary  in  a  word  or  two  of  what  has  been  dis- 
covered by  the  examining  teacher.  It  should  be 
followed  by  a  statement  regarding  the  present  ill- 
ness^ beginning  at  the  onset.  A  little  history 
should  be  given  of  the  way  the  child  learned  to 
talk  —  age  of  walking,  talking,  and  teething — 
and  then  a  notation  of  the  special  speech  influ- 
ences exerted  upon  the  child,  such  as  foreign  ac- 
cent, the  companionship  of  stutterers,  the  imita- 
tion of  home  phonetic  defects.  There  should  be 
a  record  of  the  amount  of  progress  or  retrogres- 
sion that  the  child  has  made  recently,  and  a  de- 

42 


CORRECTING  DEFECTS  OF  SPEECH 

tailed  statement  of  the  methods  of  treatment  it 
has  been  subjected  to.  The  next  item  \?>  past  his- 
tory. Here  accidents,  operations,  unusual  fright 
occurring  previous  to  the  onset,  and  any  special 
peculiarities  or  background  of  the  speech  that 
may  help  to  explain  the  speech  disorder,  should  be 
tabulated  in  detail.  The  family  history  comes 
next.  Here  should  be  mentioned  such  factors  as 
feeble-mindedness,  insanity,  mental  retardation, 
queerness,  other  speech  disorders  in  the  family 
and  relatives  of  the  case  in  hand. 

The  results  of  the  vocal  examination  should 
follow,  with  a  statement  regarding  the  general 
nature  of  the  speech,  pronunciation  of  vowels  and 
consonants,  the  amount  of  stuttering,  and  other 
similar  matters.  The  last  item  in  the  teacher's 
record  should  be  a  brief  summary  and  the  diag- 
nosis. 

There  are  other  items  that  should  be  on  the 
record,  but  which  it  is  not  the  function  of  the 
teacher  to  obtain  or  to  pass  judgment  upon.  One 
of  these  things  is  the  summary  of  the  school  phy- 
sician's medical  findings.  Transferred  to  the 
speech  defective  record,  this  will  sometimes  eas- 
ily solve  a  problem  which  is  otherwise  impossible. 
Any  notes  from  the  superintendent's  office  giving 
advice  upon  the  case  should  be  recorded.  There 

43 


SPEECH  DEFECTS  IN  CHILDREN 

should  surely  be  here  a  record  of  the  teacher's 
visits  to  clinics  and  especially  a  summary  of  the 
diagnosis  and  advice  of  any  speech  specialists 
who  have  been  consulted. 

Outlines  of  this  sort  compose  only  the  begin- 
ning of  the  record.  After  this  certainly  a  weekly, 
and  sometimes  a  daily  note  —  concise,  and  em- 
ploying vocal  terms  —  should  be  added,  with 
date,  as  the  case  progresses.  These  daily  notes 
show  progress  in  a  way  that  the  first  record  can- 
not. They  show  progress  which,  if  not  noted,  is 
hkely  to  be  forgotten,  so  that  when  the  case  is 
finally  summed  up,  the  proper  contrast  with  the 
original  condition,  and  hence  the  proper  credit  to 
the  teacher  for  elimination,  is  lost. 

The  school  physician's  use  of  the  record  is 
probably  rare,  but  the  original  findings  and  the 
record  of  improvement  may  occasionally  be  of 
some  value  in  leading  him  to  a  diagnosis. 

An  accurate,  well-kept  record  enables  the  su- 
perintendent to  decide  whether  to  return  a  case 
to  the  grades,  to  remove  it  to  an  institution,  or 
to  keep  it  in  the  speech  class. 

The  child  also  is  served  by  a  record  in  that  his 
case  can  be  taken  up  more  readily  by  a  new 
teacher  when  she  has  the  previous  findings  to 
rely  upon.   His  progress  is  put  down  as  it  really 

44 


CORRECTING  DEFECTS  OF  SPEECH 

is,  and  he  receives  credit  and  blame  as  he  de- 
serves. 

Over  and  above  all  these  things,  the  records 
may  be  used  by  the  teacher  in  publication  and  in 
this  way  she  may  gain  new  appointments  with 
wider  opportunities  for  founding  departments 
and  inaugurating  or  organizing  work  in  other 
schools. 

School  departments  for  speech  improvement 
without  records  are  unscientific  and  are  worthless 
to  future  comers.  On  the  other  hand,  scientifi- 
cally kept  and  complete  records  of  speech  cases 
are  of  inestimable  value  to  teacher,  superintend- 
ent, and  the  patient  himself.  No  department 
whatever  should  be  started  without  complete 
consideration  of  the  matter  of  records,  and  how 
to  start  them  and  maintain  them  in  regular  and 
perfect  form.  The  time  given  this  is  well  spent. 


Ill 

THE  ELIMINATION  OF  MINOR  SPEECH 
DISORDERS 

To  satisfy  the  demand  for  perfection  in  vocal 
utterance,  not  only  must  we  treat  of  the  frank 
defects  in  speech,  but  also  some  less  marked 
faults,  or  inadequacies  of  utterance. 

For  this  reason,  let  us  devote  a  chapter  to 
those  too  frequent  and  often  extremely  annoying 
minor  speech  faults  known  as  "nasality,"  "mo- 
notony," "harshness,"  "hoarseness,"  "hasty," 
and  "  slovenly  "  speech. 

/.  Nasality 

A  definition.  Nasality  is  the  so-called  "nasal" 
tone  in  the  voice  caused  by  obstruction  of  the 
nasal  passages. 

In  normal  utterances  where  m^  n^  and  ng  are 
used,  the  exit  for  air  through  the  mouth  is 
blocked.  The  stream  of  air  must  then  find  its 
only  way  of  escape  through  the  nose.  Thus  the 
nares  are  normally  used  in  the  utterance  of  these 
sounds.  When,  for  any  reason,  the  air  cannot 
pass  through  the  nose,  there  necessarily  results 

46 


MINOR  SPEECH  DISORDERS 

an  imperfect  enunciation  of  these  sounds.  They 
are  not  stopped,  or  even  changed  to  other  sounds, 
but  are  sHghtly  varied.  This  change  in  vocal 
utterance  is  called  "nasality." 

Cause.  This  blocking  of  the  nasal  passage  is 
brought  about  in  several  different  ways.  The 
simplest  cause  is  illustrated  by  holding  one's  own 
nose  during  the  utterance  of  those  sounds  which 
need  the  nasal  air  passages  for  their  free  expres- 
sion. For  those  to  whom  nasality  is  not  clear, 
this  is  a  good  way  to  learn  how  it  is  caused,  to 
hear  it,  and  thus  to  learn  how  to  detect  it  in 
others.  Hold  the  nose  and  pronounce  m^  n,  and 
ng.  Then  pronounce  the  same  sounds  with  the 
nose  free.  Better  still,  put  these  sounds  into 
some  sentence,  such  as,  "I  am  going  to  Ma- 
nila." Pronounce  the  sentence  with  and  without 
obstruction. 

Another  cause  of  nasal  obstruction  may  be 
found  in  the  ordinary  cold.  This  obstruction  usu- 
ally extends  for  some  distance  into  the  nasal  ori- 
fice and  so  causes  a  more  complete  blockage  than 
the  mere  holding  of  the  nose  with  finger  and 
thumb.  When  the  air  is  obstructed  merely  at  the 
exit,  it  can  reach  to  the  end  of  the  nose  and 
swell  it  out  to  some  extent.  But  when  the  secre- 
tions of  a  cold  in  the  nose  prevent  this,  the  re- 

47 


SPEECH  DEFECTS  IN  CHILDREN 

suiting  nasality  is  more  marked.  The  greater  the 
obstruction,  the  greater  the  nasality. 

Another  form  of  nasal  obstruction  is  an  ab- 
normal growth  in  the  nasal  passages.  This  may 
be  due  to  accident,  to  a  tumor,  or  to  the  over- 
growth of  normal  tissue.  The  first  two  may  be 
left  undiscussed,  as  they  belong  exclusively  to 
the  province  of  the  medical  specialist.  The  last 
is  so  common  and  so  often  overlooked  during 
treatment  for  nasality  that  a  word  about  it  here 
will  be  in  place.  The  overgrowths  referred  to  are 
called  adenoids.  Normally  they  are  small,  unob- 
structing  glands  in  the  posterior  nares  and  offer 
no  hindrance  to  health  or  breathing.  But  in  cer- 
tain individuals,  mostly  young  children,  the  ade- 
noids have  an  abnormal  growth  and  completely 
obstruct  the  passage  of  air  through  the  nose. 
There  results  not  only  nasality,  but  constant 
mouth  breathing  and  other  constitutional,  vocal, 
and  mental  anomalies.  Adenoids  form  a  perma- 
nent, complete,  and  serious  nasal  obstruction  that 
shows  definite  physical  signs  to  the  physician 
and  a  marked  vocal  sign  —  nasality  —  to  the 
voice  expert. 

Treatment.  In  all  these  cases  and  others  un- 
necessary to  mention  here  there  is  only  one  cause 
and  only  one  treatment.    Our  experimental  way 

48 


MINOR  SPEECH  DISORDERS 

of  causing  nasality  with  the  thumb  and  finger 
illustrates  both.  The  cause  is  always  obstruc- 
tion. The  treatment  is  removal  of  obstruction. 
The  nasality  caused  by  the  ordinary  cold  passes 
away  when  the  cold  is  overcome.  Adenoids  must 
be  removed  by  operation.  This  frees  the  passage, 
and,  if  no  bad  habits  have  intervened,  articula- 
tion assumes  its  proper  form  immediately. 

It  is  clear  from  this  brief  consideration  that 
nasahty  due  to  mechanical  obstruction  is  mostly 
a  matter  for  the  physician's  attention.  It  may 
well  be  asked,  therefore,  "  Where  is  the  teacher 
or  vocal  expert  needed  in  cases  of  nasality  ? " 
There  is  more  room,  perhaps,  for  the  teacher 
than  for  the  doctor,  as  the  latter  often  can  do  no 
more  than  prepare  the  ground  roughly  for  the 
finishing  work  of  the  former. 

During  the  years  of  talking  with  vocal  ob- 
struction, bad  habits  of  enunciation  are  usually 
formed  which  continue  after  the  obstruction  has 
been  removed  and  cannot  be  corrected  by  the 
patient  himself  without  help.  These  bad  habits 
consist  in  poor  breathing,  faulty  articulation,  and 
lack  of  vocal  flexibility.  This  matter  of  training 
after  adenoid  operations  offers  an  important  op- 
portunity to  the  vocal  trainer  which  will  be  re- 
served for  later  discussion. 

49 


SPEECH  DEFECTS  IN  CHILDREN 

The  two  points  for  the  teacher  and  voice 
trainer  to  remember  under  the  subject  of  nasal- 
ity are,  (i)  a  precaution,  not  to  treat  in  a  vocal 
way  the  nasaUty  that  is  caused  by  obstruction, 
but  to  have  that  obstruction  first  removed,  and 
(2)  to  devote  all  effort  toward  obliteration  of  the 
bad  habits  of  speech  that  persist  after  such  nasal 
obstructions  have  been  eliminated. 

2.  Monotony 

Monotony  of  voice  is  persistent  sameness  of 
pitch  and  intensity.  Though  there  are  some 
others,  these  are  the  principal  causes  of  monot- 
ony that  are  amenable  to  treatment  and  there- 
fore the  only  ones  we  need  to  consider  here. 

The  causes  of  monotony  are  numerous,  but 
the  following  are  the  most  frequently  encoun- 
tered : 

Absence  of  thought  and  emotion.  Students  of 
vocal  psychology  attribute  changes  in  the  voice 
to  a  change  in  the  mental  background.  Con- 
versely, sameness  of  voice  should  be  attributed 
to  an  unchanged  condition  of  mind.  Absence  of 
thought  and  emotion,  whatever  may  be  the  cause 
of  it,  is  a  prime  cause  of  vocal  monotony.  This 
is  clear  enough  in  the  idiot  and  imbecile,  in  whom 
we  know  thought  has  a  very  limited  range.    It  is 

50 


MINOR  SPEECH  DISORDERS 

less  easy  to  realize  that  many  of  those  about  us 
have  but  a  shght  range  of  thought  and  Httle  or 
no  emotion.  Perhaps  it  would  be  better  to  say 
that  they  have  little  change  of  thought,  little  va- 
riety in  their  emotions.  Special  study  of  those 
who  have  monotonous  voices  will  usually  reveal 
the  fact,  after  we  become  acquainted  with  their 
inner  life,  that  their  poverty  of  thought  and  emo- 
tion is  the  cause  of  their  vocal  monotony. 

Lack  of  responsiveness.  The  mind  cannot  ex- 
press itself  adequately  through  the  voice  unless 
the  vocal  mechanism  —  lungs,  vocal  cords,  and 
resonant  chambers  —  is  fitted  to  respond,  and  to 
respond  with  an  almost  infinite  delicacy  and  per- 
fection. But  in  many  voices  we  find  merely  a 
rough,  limited,  hampered  response  to  the  de- 
mands of  the  mind.  The  deficiency  is  most 
marked  when  the  voice  is  called  upon  to  render 
minutely  changing  thought  or  sweeping  changes 
in  emotion.  In  the  case  cited  above  we  have  no 
variety  of  mental  life  to  make  the  voice  flexible. 
Here  we  may  have  a  complicated  variety  in 
thought  and  emotion  coupled  with  monotony  of 
voice,  merely  because  of  a  lack  of  responsiveness 
in  the  external  vocal  mechanism. 

Conservatism,  The  mind  dominated  by  intense 
conservatism  shows  a  peculiar  monotony  of  voice 

51 


SPEECH  DEFECTS  IN   CHILDREN 

which  is  hard  to  define.  An  acquaintance  of 
mine  who  graduated  from  Harv^ard  and  taught  in 
Vermont  once  said,  when  blamed  for  the  even 
tenor  of  his  voice,  "  Well,  you  see,  I  come  from 
the  old  New  England  families  who  can't  lose 
their  heads  over  anything  modern.J^  His  words 
indicated  an  adequate  cause  of  his  vocal  unif  orm- 

Exclusive  intellectuality.  An  unvaried  intel- 
lectual life  that  leaves  no  room  for  emotion,  en- 
thusiasm, or  expressive  activity,  except  in  so  far 
as  these  are  controlled  by  the  intellectual  inter- 
ests, leads  to  monotony  of  voice.  A  Harvard 
professor  once  complained  to  a  voice  specialist 
that  his  voice  always  tired  his  audiences.  The 
reason  lay  in  the  monotony  of  voice  resulting 
from  his  constant  preoccupation  with  intellec- 
tual matters,  and  particularly  those  of  his  own 
specialty. 

Weariness.  The  monotony  of  voice  due  to  fa- 
tigue is  far  from  being  the  same  as  the  monotony 
resulting  from  a  deficient  vocal  mechanism.  The 
former  is  temporary.  The  latter  is  a  permanent 
pathological  condition,  or  lack  of  development. 

Exhausted  muscles,  vocal  cords,  and  other 
parts  of  the  vocal  mechanism  lose  the  energy 
requisite  for  a  sensitive  and  delicate  response. 

52 


MINOR  SPEECH  DISORDERS 

The  teacher  who  instructs  from  four  to  six  hours 
a  day  knows  that  the  closing  hours  —  if  monotony 
of  voice  appears  —  are  her  worst.  The  pupils  are 
not  interested,  the  work  goes  more  slowly  and  the 
class  learns  less.  Fatigue  is  a  common  cause  of 
vocal  monotony. 

Disease.  Many  forms  of  illness  result  in  a  uni- 
form vocal  pitch  and  intensity  that  is  to  be 
eradicated  only  by  attacking  the  disease  itself,  if 
curable. 

The  convalescence  of  aphasia  in  its  motor  form, 
the  severer  forms  of  chorea,  the  bulbar  form  of 
infection  with  the  spirocheta  pallida.,  permanent 
damage  to  the  muscles  of  phonation,  as  found  in 
progressive  muscular  atrophy,  and  many  other 
nerve  and  brain  conditions,  affect  the  vocal  mech- 
anism each  in  its  own  peculiar  way  and  are  to  be 
reached  and  treated  only  by  the  nerve  specialist. 
Often  the  physician  needs  to  be  called  to  deter- 
mine that  no  disease  lies  lurking  in  the  back- 
ground and  that  the  vocal  trainer  may  feel  free 
to  proceed.  And  this  suggests  the  mistake  made 
by  many  voice  trainers  —  especially  those  who 
try  to  treat  defects  in  speech  —  when  treatment 
for  defects  is  initiated  without  a  thorough  physical 
examination  by  a  competent  specialist.  Teacher 
and  physician  should  work  together,  each  in  his 

53 


SPEECH  DEFECTS  IN  CHILDREN 

proper  sphere.  Neither  should  attempt  to  usurp 
the  duties  of  the  other,  although  both  work  to- 
ward the  same  end  of  final  cure. 

Treatment.  Monotony  is  easily  treated.  Sing- 
ing lessons  are  good.  Exercises  leading  to  vocal 
flexibility  are  often  sufficient  to  correct  monotony 
in  the  speaking  voice  alone.  But  in  cases  in  which 
vocal  monotony  has  resulted  from  a  deep-rooted 
conservatism  or  from  a  too  exclusively  intellectual 
life,  a  more  extensive  and  deep-going  method  of 
cure  must  be  adopted.  Profound  psychological 
changes  must  be  effected  if  permanent  vocal  va- 
riety is  to  result.  Of  course,  it  must  always  be 
carefully  considered  whether  such  radical  and 
protracted  treatment  is  worth  while.  Most  cases 
of  vocal  monotony  are  cured  by  easier  means. 
Weariness  of  the  vocal  apparatus  is  cured  by 
rest,  and  disease  should  be  referred  to  the  phy- 
sician. 

It  is  clear,  then,  that  the  larger  proportion  of 
cases  falls  to  the  teacher.  They  are  to  be  treated 
by  the  ordinary  vocal  exercises  which  lead  to  con- 
trol of  the  breath  and  to  the  flexibility  of  the 
voice.  Through  the  judicious  use  of  these  exer- 
cises the  commoner  forms  of  vocal  monotony  are 
to  be  cured. 


54 


MINOR  SPEECH  DISORDERS 

J.  Harshness  and  hoarseness 

A  definition.  A  harsh  voice  is  one  made  rasp- 
ing, rough,  or  husky  by  the  dominance  of  some 
intense  mental  state  that  temporarily  or  perma- 
nently dispels  smoothness,  evenness,  fine  quality. 
In  other  words,  harshness  finds  its  final  cause  in 
the  persistence  of  a  mental  complex.  This  indi- 
cates a  distinction  between  harshness  and  hoarse- 
ness. The  former  is  due  to  a  mental  condition 
which  finds  its  expression  through  a  normal  vocal 
mechanism ;  the  latter,  hoarseness,  has  no  neces- 
sary connection  with  any  mental  state,  it  occurs 
in  connection  with  all  sorts  of  normal  meatal 
states,  it  is  also  possible  in  any  abnormal  mental 
state.  The  merely  rasping  and  husky  voice  is 
caused  by  some  physical  change,  like  swelling,  in- 
flammation, or  constriction  of  the  external  vocal 
mechanism.  Harshness  is  caused  by  a  mental 
state,  hoarseness  by  a  physical  state.  Vocal  harsh- 
ness may  be  due  to  a  fit  of  temper.  One  may  be- 
come hoarse  by  yelling  for  an  hour  at  a  football 
game  and  so  causing  some  irritation  of  the  vocal 
passages.  But  no  one  would  say  that  a  fit  of 
temper  makes  one  hoarse,  or  that  an  hour's  yell- 
ing makes  one's  voice  harsh.  The  distinction, 
then,  is  clear.    We  may  assert  that  harshness 

55 


SPEECH  DEFECTS  IN  CHILDREN 

is  due  to  a  mental  condition  reported  by  the 
voice. 

Harshness  and  hoarseness  are  not,  however, 
mutually  exclusive.  Hoarseness  often  clouds 
harshness,  though  the  reverse  condition  is  never 
found.  This  concealment  of  the  harsh  voice  by 
hoarseness  is  not  permanent,  but  vanishes  as  soon 
as  the  physical  cause  of  the  hoarseness  passes 
away.  Harshness  often  persists  permanently, 
since  the  mental  states  lying  back  of  it  are  often 
more  or  less  permanent.  Permanence  and  mental 
cause  are  then  the  distinguishing  criteria  of  harsh- 
ness. 

Causes.  As  we  have  seen,  the  causes  of  vocal 
harshness  must  be  enduring  mental  states,  con- 
ditions of  mind  that  persist  for  a  long  time,  atti- 
tudes that  have  become  ingrained  characteristics 
or  permanent  moods. 

Selfishness.  I  intend  no  reference  to  the  little 
passing  selfish  acts  of  everyday  life,  although 
these  are  more  or  less  reported  by  the  voice.  The 
selfishness  here  referred  to  is  deep  and  perma- 
nent —  that  which  results  from  the  feeling  that  one 
has  been  maltreated  by  a  cold,  heartless  world 
and  a  consequent  resolution  to  live  and  act  only 
for  self.  Or  the  deep-seated  selfishness  which  I 
have  in  mind  may  result  from  intense  conflict 

S6 


MINOR  SPEECH  DISORDERS 

with  the  great  selfish  interests  of  the  outer  world. 
For  example,  poverty  or  sudden  loss  may  cause 
and  enforce  a  selfishness  so  profound  that  it 
comes  to  control  our  every  act  and  finally  casts 
its  shadow  even  upon  the  voice. 

This  dominant  selfishness  may  take  many  forms, 
even  shapes  that  under  the  circumstances  seem 
justifiable :  self-preservation,  dire  need,  uncalled- 
for  self-seeking,  the  desire  for  revenge,  selfish 
ambition.  Harshness  dominates  in  the  voice  of 
Lady  Macbeth.  By  changing  one  word  in  a  quo- 
tation from  Pope  I  can  illustrate  the  important 
distinction  already  made : 

"'T  is  not  enough,  no  hoarseness  gives  offense; 
The  sound  must  seem  an  echo  to  the  sense." 

That  is,  a  merely  hoarse  voice  never  offends. 
It  is  the  ugly  voice  emanating  from  ugliness  of 
thought  that  pains  us.  It  is  not  the  bad  voice, 
but  the  bad  thought  behind  the  bad  voice,  that 
gives  offense. 

Treatment.  Hoarseness  needs  the  doctor. 
Harshness  needs  the  teacher,  the  psychologist, 
the  psycho-analyst.  Hoarseness  due  to  inflamma- 
tion and  consequent  swelling  disappears  when 
medical  measures  relieve  the  inflammation.  Ton- 
sillitis requires  local  treatment.   The  quinsy  sore 

57 


SPEECH  DEFECTS  IN  CHILDREN 

throat  must  at  once  employ  the  services  of  the 
surgeon.  Fatigue,  when  reUeved,  takes  a  conse- 
quent hoarseness  with  it.  Throat  spasm  demands 
vocal  relaxing  exercises  to  relieve  laryngeal  con- 
tractions. The  nervous  strain  often  indicated  by 
hoarseness  has  many  forms  and  as  many  modes 
of  relief.  But  these  are  matters  that  should  be 
left  to  expert  medical  care  and  which  therefore 
demand  no  minute  consideration  in  this  place. 

The  treatment  of  vocal  harshness  is  quite  an- 
other matter.  The  very  foundations  of  thought 
and  action  must  be  tapped,  exposed  to  view, 
studied,  and  then  remodeled.  As  I  have  already 
intimated,  there  is  always  a  question  whether  such 
heroic  treatment  is  worth  while  in  the  individual 
case.  On  account  of  peculiarities  in  environ- 
ment, some  lives  and  minds  are  made  hard  and  re- 
pellent by  the  very  necessity  of  self-protection. 
With  the  cases  amenable  to  treatment  a  long  pro- 
gram of  educational  remodeling  is  the  only  road 
to  permanent  recovery.  That  remodeling  con- 
sists in  instilling  higher  motives  of  conduct, 
lasting  altruistic  interests,  and  final  complete  for- 
getfulness  of  the  old,  selfish,  narrow  life.  When 
one  has  learned  the  joy  of  living  for  others,  harsh- 
ness of  voice  disappears.  Thus,  the  teacher  is 
called  upon  to  teach  and  to  exemplify  a  very  great 

S8 


MINOR  SPEECH  DISORDERS 

lesson  in  order  to  instill  a  much  less  important 
one.  She  must  eradicate  a  great  fault  —  perhaps 
the  greatest  —  before  she  can  uproot  this  com- 
paratively slight  one  — vocal  harshness.  A  young 
lady,  about  ready  as  far  as  age  was  concerned  to 
"come  out"  into  society,  found  herself,  or,  more 
exactly,  was  found  to  be  meagerly  educated,  un- 
attractive, unpleasing  in  conversation.  Moreover, 
what  none  could  explain,  she  was  harsh  in  voice. 
She  sprang  from  an  old  New  England  family  in 
which  the  inheritance  of  an  honorable  name  was 
considered  all-sufhcient,  whether  any  character, 
accomplishments,  or  worth  accompanied  this  or 
not.  Before  her  "coming  out,"  however,  she 
wanted  to  improve.  She  sought  advice,  which, 
when  followed,  made  her,  as  she  said,  "  entirely 
over."  She  was  given  some  all-absorbing,  active, 
hard  work  among  poor  people,  which  she  followed 
for  a  few  years.  Her  power  to  help  grew,  she 
saw  real  life  among  the  needy.  Previously  a  novel, 
an  evening  "dressed"  at  home,  and  hours  with 
the  embroidery  needle  at  the  fireside  had  quite 
satisfied  her  inherited  tendency  toward  industry, 
but  a  larger  life,  real  work  for  others'  good,  and 
the  demands  of  altruism  showed  her  that  her 
previous  life  had  been  narrow,  selfish,  and  really 
low. 

59 


SPEECH  DEFECTS  IN  CHILDREN 

As  a  result  of  this  profound  spiritual  change, 
the  old  voice  vanished,  when  and  how  she  knew 
not.  She  did  know  that  she  was  almost  another 
person,  and  others  knew  that  her  old  voice,  hard 
and  harsh,  had  been  somehow  replaced  by  another 
voice  that  was  smooth,  round,  rich  and  mellow. 

^.  Hasty  speech 

To  define :  A  hasty  speech  is  one  that  shows 
undue  speed  in  utterance.  By  undue  speed  of  ut- 
terance I  mean  a  quicker  succession  of  words 
than  is  called  for  by  the  circumstances  in  which 
they  are  spoken.  We  speak  of  rash  acts,  deeds 
that  are  precipitate,  acting  without  deliberation. 
We  are  now  to  discuss,  with  regard  to  speech,  a 
similar  precipitancy,  a  similar  hastening  onward 
with  speed  unwarranted  by  the  circumstances. 

Causes.  The  causes  of  hasty  speech  are  many 
and  subtle.  Imitation  is  one  of  the  often  un- 
thought-of  causes.  We  frequently  notice  certain 
other  modes  of  speech  running  in  famihes.  Pe- 
culiarities of  pronunciation,  speech  accompanied 
by  facial  twists,  even  forms  of  smiles,  run  in  a 
family.  Forms  of  gestures,  ways  and  habits  of 
eating  or  of  removing  the  hat,  of  saying  good- 
night, and  what  not,  descend  from  father  to  son. 
Comparatively  seldom  do  we  find  the  rate  of 

60 


MINOR  SPEECH  DISORDERS 

speaking  inherited,  of  course  through  the  medium 
of  habitual  imitation. 

Imagination^  vivid  and  prolific,  frequently  re- 
sults in  hasty  speech.  Those  whose  mental  crea- 
tions are  turned  off  at  a  terrific  rate  feel  that 
words  are  too  slow,  feel  that  language  retards 
them.  It  certainly  does  lag  behind  in  the  pace 
set  by  their  imaginations.  The  market  is  over- 
stocked, their  storehouse  of  thought  is  over- 
crowded and  seeks  relief.  Speed  of  speech  is  the 
only  outlet,  and  so  a  terrific  speech  is  maintained 
to  keep  pace  with  the  sweeping  speed  of  their 
imaginative  manufacture. 

The  habit  of  stuttering  is  another  frequent 
cause  of  speed  in  utterance.  The  stutterer  sees 
ahead  of  him  certain  words  over  which  he  knows 
he  is  going  to  stumble  —  certain  sounds  he  will 
have  to  repeat  perhaps  ten  times  with  severe 
muscle  contractions  of  his  throat,  even  of  his 
face,  and  sometimes  with  gross  bodily  contor- 
tions. He  has  discovered  a  trick  to  prevent  such 
anticipated  stutter— the  trick  of  whipping  up  his 
horses  and  going  at  a  breakneck  speed  past  his 
difficulty.  Having  succeeded  once  by  means  of 
this  stratagem,  he  learns  to  rely  on  speed,  until 
finally  hasty  speech  becomes  his  usual  mode  of 
vocal  production.    At  length,  whether  occasion 

$1 


SPEECH  DEFECTS  IN  CHILDREN 

calls  for  it  or  not,  he  habitually  rushes  his  words 
off  with  terrific  dispatch. 

Interruptions .  Among  refined  people  it  is  con- 
sidered impolite  for  one  to  interrupt  another  in 
conversation.  In  many  families,  however,  the 
members  break  in  upon  one  another's  speech 
with  constant  interruptions.  Rapid  utterance  is 
resorted  to  when  one  sees  an  interruption  com- 
ing in  order  to  finish  what  one  has  to  say  before 
being  cut  off  —  sometimes  even  to  succeed  in 
getting  a  word  in  edgewise. 

Other  causes  there  are,  but  since  the  treatment 
varies  little  from  case  to  case,  whatever  the  cause 
may  be,  let  us  proceed  to  consider : 

Treatme7it.  In  the  treatment  of  this  as  of  all 
other  forms  of  vocal  defect,  one  must  first  elicit 
a  desire  and  ambition  for  normal  utterance.  With- 
out this  desire  and  ambition  for  normal  speech  it 
is  impossible  to  get  any  one  to  go  through  the 
steps  necessary  to  its  attainment. 

If  the  difficulty  is  due  to  an  abnormally  swift 
and  prolific  imagination  —  if  the  unhappy  pos- 
sessor of  the  hasty  voice  thinks  like  the  three 
witches  in  Macbeth  from  one  end  of  the  universe 
to  the  other,  in  an  instant  including  everything 
between,  then  I  must  confess  that  I  know  hardly 
any  cure.  Who  can  curb  the  flight  of  a  witch's 

62 


MINOR  SPEECH  DISORDERS 

imagination ;  who  can  cut  short  such  copious  and 
prolific  manufacture  of  visual  pictures ;  who  can 
control  a  mind  thus  wildly  let  loose  ?  There  are, 
however,  certain  precautions  which  one  may  at- 
tempt, such  as  moderation,  reserve,  inhibition  of 
expression.  One  may  use  the  sedative  of  self- 
control,  and  this,  after  years  of  practice,  may  re- 
sult in  some  change.  Here  the  task  is  difficult 
and  hardly  worth  while  in  the  face  of  the  truth 
that  hasty  speech  is  not  such  a  terrible  misde- 
meanor after  all.  We  should  count  the  cost  and 
see  if  the  long  effort  necessary  to  cure  is  likely 
to  be  justified  by  the  result. 

If  fear  of  stuttering  is  the  promoter  of  rapid 
utterance  there  is  at  first  but  one  step  to  take — 
refer  the  sufferer  to  some  reliable  practitioner 
and  voice  specialist  or  to  a  lay  teacher  thoroughly 
trained  under  the  personal  direction  of  such  an 
expert. 

Stuttering  is  a  pretty  serious  condition,  as  it 
excludes  the  possessor  from  all  kinds  of  normal 
social  intercourse.  It  often  makes  friendships  im- 
possible ;  it  postpones  or  entirely  prevents  mar- 
riage ;  many  times  it  prevents  a  man  from  ob- 
taining permanent  employment.  Such  a  serious 
condition  should  be  under  the  care  of  the  vocal  ex- 
pert so  as  to  avoid  the  relapses  that  so  frequently 

63 


SPEECH  DEFECTS  IN  CHILDREN 

occur  when  the  casual,  untrained  teacher  is  em- 
ployed. Training  for  moderate  speed  of  speech  will 
not  cure  stuttering ;  it  may  temporarily,  or  rather, 
momentarily,  sidetrack  the  malady.  A  permanent 
cure,  however,  requires  a  reformation  of  the  inner 
personality  by  a  long  process  of  psychological 
analysis  and  synthesis.  This  subject  —  the  treat- 
ment of  stuttering  —  is  too  large  for  adequate 
consideration  here.  The  only  phase  of  it  that 
logically  comes  up  for  consideration  has  to  do 
with  the  speed  of  the  stutterer's  utterance.  This 
sometimes  lasts  after  the  recovery  and  sometimes 
is  the  main  part  of  the  stutterer's  habit.  A  good 
way  to  overcome  this  is  to  have  the  stutterer  talk 
with  a  metronome  ticking  at  the  precise  rate  at 
which  you  wish  him  to  utter  his  words.  This, 
however,  is  a  mechanistic  and  external  treatment. 
The  better  and  the  psychological  method  is  to 
get  slowness  through  mental  concepts,  and  their 
installation,  as  a  permanent  mental  possession  — ■ 
the  control  of  motor  output  by  instillation  of  sen- 
sory content. 

Summary :  Hasty  voice  comes  out  of  impell- 
ing mental  complexes  —  the  demand  of  imitation, 
the  effort  to  keep  up  with  the  flight  of  imagina- 
tion, the  resort  to  speed  to  sidetrack  a  stutter — 
concepts  that  sidetrack  inhibition,  and  allow  ut- 

64 


MINOR  SPEECH  DISORDERS 

terance  in  uncalled-for  speed.  Briefly,  the  treat- 
ment consists  in  annulling  the  causes,  reinstating 
a  normal  inhibition,  and  implanting  new  constel- 
lations of  ideas  that  work  as  complexes  for  slow- 
ness. 

5.  Slovenly  speech 

As  slovenly  dress  differs  from  dirty,  faded, 
and  ragged  dress,  so  slovenly  speech  differs  from 
nasality,  monotony,  harshness,  hoarseness,  and 
hasty  speech.  It  is,  in  reality,  unduly  relaxed, 
lazy  speech.  It  results  from  a  lack  of  careful 
mental  guidance,  from  carelessness  in  following 
articulation  models. 

Mental  states  of  dejection,  weariness,  submis- 
sion to  a  power  recognized  as  higher  than  that 
of  the  individual's  will,  report  themselves  in  the 
voice  and  show  in  what  is  here  named  slovenly 
speech.  Countries  in  which  women  are  very  sub- 
missive, as  they  are  in  Russia  and  certain  parts 
of  Germany,  are  likely  to  be  countries  in  which  the 
women  are  slovenly  in  attire,  physical  attitude, 
and  voice.  The  three  things  are  usually  found 
together,  since  they  are  all  equally  the  exterior- 
ization of  one  mental  state. 

What  sort  of  mental  state  is  this  ?  It  may  be 
described  as  a  state  of  listlessness.  Where  the 

6s 


SPEECH  DEFECTS  IN  CHILDREN 

dress  lacks  neatness  and  refinement,  the  voice  is 
likely  to  lack  precision  and  subtle  gradation  of 
tone  and  quality.  In  slovenly  speech  all  the  life, 
enthusiasm  and  animation  of  normal  utterance  are 
gone.  It  is  like  a  befogged  picture,  a  misted 
landscape. 

I  remember  the  case  of  a  young  man  upon 
whom  three  disasters  fell  in  one  day.  He  failed  in 
his  entrance  examinations  at  Harvard ;  his  father 
lost  all  his  money ;  his  mother,  in  consequence, 
went  insane.  The  weight  of  this  threefold  mis- 
fortune made  him  for  a  time  utterly  dejected, 
purposeless,  without  interest  in  life,  and  the 
whole  experience  resulted  temporarily  in  a  slov- 
enly voice. 

Children  who  are  forced  to  work  too  early  in 
life  and  who  have  not  been  given  adequate  in- 
struction in  manners  and  morals  are  likely  to  be 
slovenly  in  speech.  So  also  are  the  wives  of  tyran- 
nical husbands  and  men  who  spend  their  lives  in 
subordinate  positions,  always  doing  menial  labor. 
Degradation,  poverty,  and  neglect  make  people 
slovenly,  but  not  always.  Many  escape.  For  this 
reason,  it  seems  clear  that  there  is  nothing  inev- 
itable in  such  a  result.  A  will  sufficiently  alert 
and  strong  can  avoid  this  consequence,  even 
under  the  most  depressing  external  conditions. 

66 


MINOR  SPEECH  DISORDERS 

Imitation  of  older  members  of  the  family  fre- 
quently causes  slovenly  habits  and  slovenly  speech 
in  children,  but  this  powerful  influence  also  may 
be  overcome. 

The  treatment  for  slovenly  speech  is  largely 
psychological  and  moral.  Self-respect  and  a  de- 
sire for  the  respect  of  others  must  be  instilled. 
In  the  case  of  those  who  are  timid,  withdrawing, 
unduly  submissive,  it  is  well  to  instill  ideas  of  the 
moral,  civil,  and  social  equality  of  all  men.  It  will 
be  found  that  as  the  patient  comes  to  take  a  more 
exalted  view  of  his  own  powers  and  position  in 
the  world,  his  slovenly  manners  and  speech  will 
fall  gradually  and  naturally  away  from  him. 


IV 


HOW  THE  TEACHER  MAY  ACQUIRE  A  PROPER 
STANDARD  OF  SPEECH 

Proper  standards  of  speech  are  to  be  attained 
only  by  taking  a  larger  view  of  speech  than  most 
teachers  seem  to  have.  When  the  teacher  has 
studied  the  subject,  when  she  has,  for  example, 
taken  summer  courses  and  has  had  a  year's  ex- 
perience in  practical  work,  then,  to  be  sure,  she 
should  be  capable  of  this  larger  view  to  which  I 
refer,  but  no  one  can  attain  it  by  listening  to  a 
few  words  of  instruction,  by  reading  a  book,  or 
even  by  seeing  in  class,  on  the  stage,  or  in  the 
clinic,  the  outward  expression  of  its  attainment. 
One  really  has  to  pass  through  the  training  him- 
self. Here,  as  in  religion,  one  has  to  "live  the 
life  to  know  the  law." 

To  indicate,  as  far  as  can  be  done  by  the 
printed  word,  this  larger  conception,  and  fuller 
appreciation  of  speech  is  the  purpose  of  the  fol- 
lowing paragraphs. 

The  study  of  the  voice  and  of  speech  has  many 
phases.  Some  are  more  necessary  than  others. 

68 


A  PROPER  STANDARD  OF  SPEECH 

A  few  may  seem  to  the  uninitiated  quite  unnec- 
essary. When  speech  is  understood  in  a  broad 
sense,  however,  and  its  scope  and  complexity  are 
appreciated,  when  one  sees  the  full  difficulty  and 
importance  of  the  speech  problem  in  schools, 
then  it  becomes  clear  that  the  teacher  should  add 
to  her  equipment  year  by  year  until  finally  she 
becomes  invulnerable  in  knowledge  and  versa- 
tility. 

I  propose  to  suggest  places  and  ways  in  which 
to  obtain  this  knowledge.  Also  I  wish  to  show 
the  utter  inadequacy  of  the  poorly  trained  and 
the  danger,  even  to  the  teacher  herself,  of  inade- 
quate equipment. 

I,   Time  spent  in  regular  grade  work 

Teachers  know  that  even  when  they  graduate 
from  the  normal  school  they  are  sufficiently  inex- 
perienced. They  realize  this  still  more  keenly 
after  they  have  taught  two  or  three  years.  The 
schools  where  they  are  first  employed  realize  the 
same  thing. 

The  speech  teacher  also  needs  experience  in 
the  grades.  Without  such  experience,  she  does  not 
realize  how  to  start  with  a  class  nor  how  to  man- 
age a  group  of  children.  A  teacher  who  has  had 
several  years  of  experience  has  no  difficulties  of 

69 


SPEECH  DEFECTS  IN  CHILDREN 

this  sort.  The  experienced  teacher  knows  how 
children  learn  ;  she  knows  how  quickly  they  for- 
get ;  she  knows  how  frequently  they  need  re- 
view ;  she  knows,  too,  how  easily  they  get  into 
wrong  habits  ;  how  they  are  prone  to  evade  their 
superiors,  and  finally,  how  easily  they  may  be  di- 
rected by  the  tactful  guide. 

Regular  grade  work  is  an  important  asset  to 
the  speech  teacher.  I  should  recommend  at  least 
a  year  of  it.  Those  who  have  had  two  or  three 
years  are  naturally  better  fitted.  Occasionally  I 
have  found  a  teacher  who  has  had  ten  years  of 
grade  work  before  starting  in  speech,  but  this,  of 
course,  is  exceptional  and  really  unnecessary.  In- 
structors in  the  schools  from  which  speech  teach- 
ers are  turned  out  ought  to  require  a  year  or  two 
of  training  in  the  grades  as  a  requisite  for  admis- 
sion. From  this  word  on  general  grade  work  and 
its  value  to  the  speech  teacher,  let  us  pass  to 
some  other  forms  of  education  and  personal  de- 
velopment, accomplishments  that  help  in  the 
management  of  the  class  for  defective  speech. 

2.    Value  of  elocution^  music,  psychology 

Elocution,  oratory,  oral  English,  public  speak- 
ing, or  whatever  one  may  call  it,  is  a  sphere  of 
training  that  adds  greatly  to  the  training  of  the 

70 


A  PROPER  STANDARD   OF  SPEECH 

speech  teacher.  I  do  not  refer  here  to  that  mere 
reading  knowledge  to  be  derived  from  the  books 
on  pubhc  speaking,  nor  do  I  refer  to  the  super- 
ficial experience  to  be  gained  in  a  few  lessons  with 
a  private  elocution  teacher.  I  do  not  refer  to  the 
mere  committing  selections  to  memory  and  the 
giving  of  them  in  solitude  or  even  in  public. 
Those  who  have  done  no  more  than  this  are  com- 
paratively ignorant  of  the  field  and,  if  they  claim 
much,  they  are  mere  pretenders.  In  order  to  pur- 
sue the  study  of  oratory  worthily  and  properly 
one  should  go  through  one  of  the  recognized 
schools.  Only  so  can  one  hope  to  develop  step  by 
step  through  the  long  stages  of  oratorical  evo- 
lution toward  anything  resembling  the  mental 
powers  and  characteristics  of  the  expert  actors. 

The  proper  study  of  oratory  brings  personal 
development  as  well  as  knowledge  of  how  the 
minds  of  others  may  be  unfolded.  It  shows  the 
scope  of  imagination  and  raises  one's  ideals  of 
vocal  and  phonetic  execution. 

Musical  ability  is  another  aid  to  the  teacher  in 
the  classroom  for  speech  disorder  and  cannot  but 
add  enjoyment  and  success  to  her  management. 
The  utility  of  the  piano  in  such  a  classroom  is 
obvious.  Singing  can  be  occasionally  introduced  to 
break  up  the  monotony  of  vocal  exercises,  and  the 

71 


SPEECH  DEFECTS  IN  CHILDREN 

possession  of  musical  knowledge  helps  one  in  the 
understanding  of  phonetics  and  mental  functions. 
A  knowledge  of  psychology  is  invaluable.  Elo- 
cution is  based  upon  psychology,  but  upon  an  in- 
dividual, living,  functional,  active,  psychology.  I 
speak  now  of  academic  psychology.  This  refers 
much  more  to  what  is  true  of  the  mind  in  gen- 
eral than  to  what  is  true  of  individual  mentality. 
Psychology  should  be  studied  in  summer  courses 
and  by  reading,  by  introspection,  and  by  re- 
searches in  the  classroom. 

J.  Phonetics  not  to  be  learned  from  books 

The  idea  that  the  whole  science  of  phonetics, 
including,  of  course,  methods  of  correcting  de- 
fects, can  be  learned  exclusively  from  books,  is 
so  common  a  misconception  that  I  have  thought 
it  worth  while  to  attack  it  directly  and  vigorously. 
Granted  that  something  can  be  learned  in  this 
way  —  perhaps  a  third  —  in  such  subjects  as  this, 
however,  the  ear  is  the  special  avenue  of  knowl- 
edge. Printed  words  can  give  at  best  a  very 
meager  description  of  anything  phonetic,  whether 
it  be  the  simple  description  of  normal  utterances, 
methods  of  phonetic  treatment,  or  processes  of 
evolution  from  the  beginning  of  utterances  to  the 
final  perfection  thereof. 

72 


A  PROPER  STANDARD  OF  SPEECH 

Describe  the  voice,  for  example,  of  some  great 
man  and  say  that  his  speech  was  emotional,  had 
volume,  flexibility,  and  clearness.  To  the  initiated 
these  terms  mean  more  perhaps  than  to  others, 
but  how  far  is  that  description  from  the  real  voice 
itself  1 

Let  me  add  an  illustration  of  this  important 
fact  that  some  sorts  of  knowledge  are  communi- 
cable almost  solely  through  the  ear.  The  singing 
teachers  of  to-day  feel  a  real  superiority  to  their 
fellows  of  the  younger  generation  in  being  able 
to  say,  "  I  have  heard  Patti."  They  really  feel 
that  they  can  communicate  a  peculiar  excellence 
because  they  have  a  peculiar  ideal,  that  they  have 
a  sort  of  refinement  gained  through  the  hearing 
of  this  great  singer,  which  those  who  have  never 
heard  her  cannot  possibly  ever  possess. 

Ideals  of  phonetic  excellence  can  be  obtained 
only  by  actual  study  under  the  masters  of  pho- 
netic execution ;  by  actually  hearing  the  utterances 
that  illustrate  absence  of  different  functions  in 
the  nervous  system,  by  actually  seeing  experts 
vary  and  change  voices  under  treatment,  by  ac- 
tually hearing  that  change  itself  and  learning  to 
interpret  it,  by  actually  listening,  under  direction, 
to  a  great  variety  of  speech  defects  as  well  as  to 
normal  and  highly  developed  speech. 

73 


SPEECH  DEFECTS  IN  CHILDREN 

Books,  then,  carry  but  a  little  way  in  this  study. 
One  must  learn  to  hear,  he  must  expand  and  re- 
fine his  interpretations  of  what  is  heard,  he  must 
learn  under  expert  guidance  to  think  upon  aural 
sensations,  so  that  all  this  may  formulate  an  ideal 
output. 

^.  Special  training  for  the  correction  of  stutterers 

All  sorts  of  persons  consider  themselves  fitted 
by  attainments  or  by  nature  to  treat  stuttering. 
Persons  who  have  been  cured  of  stuttering  by 
some  one  else,  others  who  have  cured  themselves, 
and  —  I  mention  it  with  a  blush  and  a  shudder 
—  sometimes  even  uncured  stutterers  who,  be- 
cause they  have  the  disease,  claim  a  knowledge 
of  it,  offer  their  services  in  the  effort  to  cure 
others.  This  sounds  plausible  and  right  only  to 
the  ignorant  and  unsophisticated. 

The  training  necessary  to  one  who  undertakes 
to  treat  stuttering  is  more  extensive  than  one  is 
likely  to  imagine.  One  must  show  tact  in  the 
management  of  patients.  Every  patient  must  be 
given  a  physical  examination  in  order  to  eliminate 
any  physical  ailment  which  may  be  a  cause  of  the 
speech  disorder  or  may  be  sapping  vitality  and  so 
preventing  recovery.  The  teacher  should  know 
something  about  the  history  of  treatment  for 

74 


A  PROPER  STANDARD  OF  SPEECH  ^ 

stuttering.  She  should  know  the  modern  psycho- 
logical investigations  in  both  the  conscious  and 
the  subconscious  fields.  She  should  know  the 
value  of  visualization  processes  in  relation  to 
stuttering.  Above  all,  she  should  realize  the  im- 
portance and  value  of  what  is  vaguely  called  sug- 
gestive therapeutics. 

Teachers  trained  for  speech  improvement 
should  not  be  discouraged  by  these  high  stand- 
ards. These  standards  do  not  prevent  one's  be- 
ginning teaching  in  a  small  way.  One  can  begin 
work  in  speech  instruction  with  only  a  little  prep- 
aration. The  bigness  of  the  field  coupled  with 
the  small  requirements  for  entrance  to  it  should 
lure  numerous  teachers  to  the  undertaking.  Let 
us  not  be  satisfied,  however,  with  this  modest 
beginning,  but  let  us  add  constantly  to  our  equip- 
ment. 

5.  Special  training  for  the  "  special  class  " 

In  the  "  special  class  "  are  included  all  grades 
df  mental  defectives  from  the  idiot  and  the  im- 
becile to  the  moron  and  the  specialized  defect. 
The  application  of  speech  improvement  to  this 
class  is  our  present  problem. 

Normal  phonetics  is  usually  tried  upon  these 
cases.    That  this  is  folly  has  been  shown  else- 

75 


SPEECH  DEFECTS  IN  CHILDREN 

where.  The  systems  and  methods  mentioned  in 
our  closing  pages  show  this  conclusively.  The 
speech  teacher  who  is  called  upon  to  conduct 
such  a  special  class  should  seek  instruction  in 
places  where  a  special  phonetic  system  is  applied 
to  these  pathological  cases ;  she  should  learn  the 
methods  of  examination  and  treatment  peculiarly 
adapted  to  them  and  should  get  to  know  their 
psychological  background. 

6.  Where  to  go  for  training 

Two  or  three  medical  schools,  one  or  two  uni- 
versities, several  private  individuals,  and  a  num- 
ber of  speech  experts  abroad,  offer  expert  instruc- 
tion in  speech  disorders.  I  will  try  to  mention 
these  in  the  order  in  which  they  were  founded. 
They  are:  The  Medical  School  of  Philadelphia, 
the  Rush  Medical  School  in  Chicago,  the  Har- 
vard Graduate  School  of  Medicine  in  Boston,  the 
Columbia  Medical  School  in  New  York  City,  the 
State  University,  Columbus,  Ohio.  I  hardly  think 
the  names  of  private  individuals  are  needed. 

One  should  not  allow  considerations  of  distance 
or  expense  to  interfere  with  one's  choice  of  the 
school  that  affords  the  best  possible  training. 
The  fact  that  schools,  like  individuals,  have  spe- 
cialties, makes  it  advisable  to  attend  several  insti- 

76 


A  PROPER  STANDARD   OF  SPEECH 

tutions  in  order  to  complete  one's  equipment. 
One  should  never  feel  that  any  single  master, 
even  the  greatest,  can  teach  all  that  there  is  to 
know  about  so  complex  a  subject.  One  should 
have  as  many  masters  as  possible. 

The  first  question,  however,  is  where  to  begin. 
This  somewhat  depends  upon  one's  previous 
study,  whether  he  has  already  had  training  in 
psychology,  elocution,  and  regular  grade  work,  or 
whether  he  is  entirely  a  novice. 

Choice  of  a  master  is  best  made  by  frankly 
writing  to  all  those  who  offer  courses  in  speech 
disorder  and  asking  them  for  details  of  their 
courses,  with  a  list  of  steps  in  their  training  and 
addresses  of  students.  Then  I  should  carefully 
compare  the  answers  received  to  discover  which 
are  merely  throat  men,  which  have  studied  only 
oratory  in  addition  to  medicine,  which  have  stud- 
ied abroad,  and  which,  finally,  have  thorough 
training  in  all  the  fields  of  knowledge  that  can 
be  in  any  way  helpful  to  their  work.  In  all  this, 
of  course,  one  should  remember  the  value  of  the 
specialist.  I  know,  for  example,  of  only  one  man 
who  offers  a  course  in  the  neuropathology  of  the 
speech  mechanism.  I  should  write  to  about  five 
student  references  and  find  out  if  their  courses 
were  satisfactory,  if  they  got  what  they  went  for, 

77 


SPEECH  DEFECTS  IN  CHILDREN 

if  the  teachers  seemed  to  know  their  subject,  and 
if  the  methods  they  inculcated  were  really  effec- 
tive in  actually  curing  patients. 

7.  Is  medical  knowledge  necessary  f 

There  can  be  no  doubt  that  the  problem  of 
speech  disorder  is  a  medical  problem.  The  few 
who  deny  this  might  as  well  say  that  nursing  is 
not  medical.  The  fact  that  much  of  the  treatment 
is  educational  makes  no  difference ;  the  fact  that 
a  knowledge  of  psychology  is  necessary  does  not 
alter  the  case.  A  medical  problem  it  is.  The 
question  arises,  then,  is  medical  knowledge  neces- 
sary, and  if  so,  what  sort  and  extent  of  medical 
knowledge  ? 

Some  physicians  have  grasped  the  opportunity 
offered  to  them  in  the  problems  of  speech  and 
have  found  the  work  lucrative,  interesting,  and 
of  great  value.  There  are  localities,  however, 
where  medical  men  fail  or  refuse  to  understand 
the  situation.  They  are  like  a  New  York  lawyer 
of  whom  I  once  heard.  One  on  the  opposite  side 
of  the  case  asked  him,  "  Can't  you  see  that  ?  '* 
His  answer  was,  "  Yes,  sir ;  but  I  won't."  Such 
men  finally  discover  that  their  exclusiveness  has 
succeeded  only  in  excluding  themselves. 

Where  medical  men  refuse  to  take  up  the 

78 


A  PROPER  STANDARD  OF  SPEECH 

speech  problem  in  a  diagnostic  way  I  advise  my 
own  teachers  to  become  acquainted  with  the  medi- 
cal side  and  to  usurp  the  activities  of  the  physician 
in  as  full  and  scientific  a  way  as  possible. 

Medical  knowledge  is  a  great  asset  to  the 
teacher.  It  solves  many  otherwise  insoluble  prob- 
lems ;  it  explains  some  of  her  failures  and  excuses 
her  to  herself  and  to  the  superintendent.  I  always 
try  first  to  open  the  field  to  the  physician  so  that 
he  may  take  his  proper  place  in  the  school  cur- 
riculum and  in  the  speech  circle,  but  when  he 
refuses,  I  try  to  inspire  the  teacher  to  do  what 
the  medical  man  can't  or  won't  do.  In  case  this 
induces  the  medical  man  to  come  later,  my  answer 
is  "too  late."  Medical  men  have  refused  to  go  into 
the  field  of  specialized  suggestive  therapy,  and  as 
a  consequence  laymen  to-day  have  their  patients. 
The  speech-disorder  problem  is  similar.  It  has 
previously  been  mostly  in  the  hands  of  charlatans 
and  impostors,  using  veiled,  suggestive  therapeu- 
tics without  knowing  the  reason  for  their  cures. 
Now  this  field  is  being  returned  to  the  medical 
profession,  but  in  those  cases  where  he  does  not 
seize  his  opportunity,  the  teacher  can  do  no  bet- 
ter than  to  take  his  place. 

In  a  word,  speech  defect  is  a  medical  problem 
and  medical  knowledge  is  often  necessary.    If  a 

79 


SPEECH  DEFECTS  IN  CHILDREN 

physician's  services  are  available,  that  is  enough. 
If  not,  let  the  teacher  take  the  physician's  place, 
do  his  work,  and  take  his  pay. 

8.    Value  of  work  in  a  special  clinic 

The  teacher's  own  standards  of  speech  should 
be  as  high  as  possible  if  she  is  to  carry  her  pupils 
to  the  highest  possible  attainments.  We  cannot 
lift  others  in  religion  or  ethics  to  any  higher  plane 
than  that  on  which  we  live  ourselves.  It  is  the 
same  in  speech.  The  teacher's  class  will  not  rise 
to  a  standard  of  speech  higher  than  her  own. 

There  is  no  better  way  of  securing  a  proper 
standard  of  speech  than  that  to  be  found  in  long 
service  in  a  special  clinic  for  speech  disorders. 
This  clinical  experience  should  follow  the  period 
of  didactic  instruction  and  should  be  followed  in 
turn  by  a  period  in  which  the  learner  watches  in 
that  speech  clinic ;  and  following  this,  a  period  of 
watching  an  expert  examine  and  treat  cases.  This 
observation  of  the  work  of  others  should  be  fol- 
lowed by  an  application  of  the  same  technique 
to  the  old  and  new  patients  in  the  same  clinic 
under  the  criticism  of  the  expert  speech  specialist. 

Besides  these  there  are  other  things  that  make 
the  service  in  a  speech  clinic  of  inestimable  value 
and  interest.    One  of  these  is  the  carrying  for- 

80 


A  PROPER  STANDARD  OF  SPEECH 

ward  of  researches,  the  compilation  of  data,  the 
reading  of  papers.  I  should  choose  a  clinic  con- 
ducted by  a  man  interested  not  only  in  treatment 
but  in  research,  a  clinic  in  which  there  are  public 
meetings  and  the  reading  of  papers.  All  these 
things  add  zest,  interest,  and  enthusiasm  to  the 
work,  and  improve  the  equipment  of  students. 

Speech  clinics  that  do  no  teaching,  that  carry 
on  no  researches,  get  out  no  papers,  and  have  no 
"authors'  evenings,"  are  uninteresting  and  unpro- 
gressive.  Each  of  these  activities  increases  the 
value  and  excellence  of  every  other  one.  Research 
improves  treatment.  Preparation  of  papers  gives 
research  and  treatment  added  momentum,  and 
the  occasion  of  the  author's  evening  or  "read- 
ing "  adds  an  enthusiasm  to  the  work  of  the  clinic 
which  can  be  secured  in  no  other  way. 

CUnical  work  gives  the  teacher  a  deeper  insight 
into  treatment,  gives  her  the  research  spirit,  in- 
cites her  to  publication.  All  this  leads  to  new 
and  better  appointments.  By  long  experience  in 
the  clinical  work  she  sees  the  folly  of  applying 
one  and  the  "  only  method  "  to  every  case ;  she 
learns  that  every  case  is  different  from  every 
other  and  therefore  requires  a  new  and  different 
method  of  approach.  The  teacher  should  investi- 
gate all  these  things  before  she  studies  anywhere. 

Si 


SPEECH  DEFECTS  IN  CHILDREN 

p.    Visiting  other  schools 

Didactic  lectures,  speech-clinic  service,  read- 
ing, actual  experience  in  teaching  —  these  are 
among  the  best  ways  of  perfecting  that  proper 
standard  of  speech  which  should  be  the  final  pos- 
session of  every  efficient  teacher. 

In  the  visiting  of  other  schools,  however,  one 
is  likely  to  find  important  additions  to  and  correc- 
tions of  his  own  methods,  no  matter  how  perfect 
he  may  think  they  have  been.  Experienced  teach- 
ers who  have  studied  under  other  masters  can 
provide  a  somewhat  different  perspective  and 
can  illustrate  points  of  view  that  we  had  not 
thought  of. 

The  author  has  made  three  surveys  of  the  work 
in  correction  of  speech  disorders  done  in  the  pub- 
lic schools.  In  all,  I  have  visited  some  twenty- 
five  cities  of  the  United  States,  trying  to  ascertain 
what  ways  and  means  have  been  employed  and 
what  results  have  been  secured.  I  have  learned 
much  from  these  surveys,  and  I  most  strongly 
recommend  the  school  visit,  therefore,  to  the 
teacher  who  has  less  acquaintance  with  the  work 
than  my  own  twenty  years  of  experience  have 
given  me.  The  novice,  however,  can  learn  little 
in  this  way. 

82 


A  PROPER  STANDARD  OF  SPEECH 

Programs  for  school  visitations  should  be  made 
regularly.  Once  or  twice  a  year  a  teacher  should 
have  a  week  off  and  visit  a  neighboring  city.  Oc- 
casionally she  should  travel  farther  to  attend  large 
educational  meetings,  hear  the  papers  of  other 
teachers,  and  in  this  way  get  new  knowledge  and 
new  methods. 

10,    The  pitfalls  for  the  poorly  trained  teacher 

The  ideals  of  speech  work  hinted  at  in  the 
previous  pages  put  the  standard  of  attainment 
and  the  final  goal  of  excellence  on  a  pretty  high 
plane.  It  will  be  well,  therefore,  to  spend  a  few 
paragraphs  in  discussing  the  dangers  which  beset 
the  specialist  who  falls  short  of  this  high  ideal 
of  equipment. 

It  will  be  well  to  begin  with  the  lowest  in  the 
scale  —  with  utter  incompetency  and  ignorance. 
One  does  not  need  to  question  the  sincerity  of 
these  inefficient  practitioners.  It  is  their  ineffi- 
ciency with  which  we  are  here  concerned.  A  con- 
crete case  will  illustrate  my  point.  I  know  of  an 
instance  in  which  a  child  with  defective  speech 
was  written  to  by  a  distant  private  individual  who 
had  not  seen  the  case  or  tried  to  know  anything 
about  its  medical  background,  but  who  promised 
complete  cure  in  three  months  at  the  rate  of  one 

83 


SPEECH  DEFECTS  IN  CHILDREN 

hundred  dollars  a  month.  The  mother  of  this 
child  had  five  hundred  dollars  in  the  bank.  It 
took  her  other  two  hundred  dollars  to  transport 
her  child,  keep  him  in  the  distant  city  for  three 
months,  and  bring  him  home.  After  his  return 
he  was  taken  to  a  charity  clinic  where  he  paid 
nothing  for  expert  opinion  which,  in  the  course 
of  about  two  hours,  established  the  fact  that  the 
case  was  one  of  congenital  syphilis.  On  this  basis 
the  physician  was  able  to  say  that  nothing  what- 
ever could  be  done  to  improve  the  speech.  I 
cannot  call  this  performance  anything  but  down- 
right robbery,  for  no  improvement  resulted. 

Numerous  cases  have  come  to  me  from  teach- 
ers in  the  public  schools.  They  can  be  classed 
as  stuttering,  phonetic,  and  mentally  defective 
cases.  I  have  known  stutterers  who  have  been 
treated  for  two  years  without  any  improvement. 
Investigation  of  the  methods  employed  showed 
that  the  teachers  who  applied  the  treatment  for 
stuttering  knew  absolutely  nothing  about  the 
cause  of  cure  in  any  successful  treatment.  They 
put  all  cases  through  the  same  regular  routine. 
If  a  third  or  so  improved,  they  seemed  to  think 
that  there  was  no  reason  why  the  others  should 
not.  I  have  repeatedly  asked  such  teachers  how 
the  stutterer  was  cured,  and  I  find  that  where 

84 


A  PROPER  STANDARD  OF  SPEECH 

failures  are  frequent,  there  is  constantly  this  ig- 
norance as  to  the  proper  cure  for  stuttering. 

Phonetic  cases  are  attacked  by  the  untrained 
teacher  by  a  parrot-like  method.  She  has  been 
studying  some  book,  little  knowing  that  from 
books  one  can  learn  little  of  phonetics,  or  she 
may  have  been  attending  some  superficial  course 
of  lectures  in  which  her  attention  has  been  ab- 
sorbed in  the  mere  mechanism  of  speech.  She 
has  learned  little  rules  and  directions  by  which 
phonetic  defects  are  supposed  to  be  corrected, 
and  she  applies  them  all,  parrot-like,  to  every 
case.  She  may  even  have  been  cured  of  one  de- 
fect, such  as  lisping,  herself.  On  this  basis  she 
considers  herself  competent  to  teach  not  only 
other  lispers  but  all  mispronouncers. 

This  is  the  condition  of  those  who  think  that 
speech  is  not  a  medical  problem.  Such  persons 
often  exhibit,  in  exact  proportion  to  the  amount 
of  their  ignorance,  a  happy  optimism  and  a  pro- 
fuse array  of  promises  of  recovery  that  often 
stagger  the  speech  expert.  Of  course  they  cap- 
ture the  patient  and  entice  the  ignorant  layman. 
The  guarantee  of  cure,  which  science  fears  to 
give,  allures  the  unwary. 

Mental  defective  speech  cases  are  those  in  which 
the  hopeful,  altruistic  teacher  makes  her  most 

8s 


SPEECH  DEFECTS  IN  CHILDREN 

signal  failure.  I  have  seen  numerous  cases  of 
mental  defect  treated  for  months  and  sometimes 
for  years  with  little  or  no  progress.  We  are  accus- 
tomed to  excuse  such  performances  on  the  ground 
that  the  teacher  did  not  know  any  better,  having 
been  trained  only  in  normal  phonetics  when  she 
should  have  been  trained  also  in  methods  appli- 
cable to  pathological  cases.  Her  action  is  not 
dissimilar  to  the  practice  of  medicine  without  a 
license.  If  there  were  any  danger  in  the  use  of 
her  appliances,  if  there  were  any  use  of  medicine 
in  the  technical  sense,  then  she  would  be  liable 
in  law.  The  spirit  of  the  law  reaches  farther  than 
the  law  itself.  She  is  defying  the  spirit  of  the 
law  when  she  ignorantly  takes  up  these  medical 
cases  without  proper  medical  speech  training. 
Her  ignorance  makes  no  difference  in  the  eye  of 
the  law,  and  it  should  surely  make  no  difference 
here.  I  consider  her  action  a  punishable  offense. 
Inadequate  training,  finally,  is  dangerous  to 
the  teacher  in  her  own  person.  The  sense  of  in- 
adequacy coupled  with  the  sense  of  great  respon- 
sibility which  every  teacher  engaged  in  speech 
work  must  feel,  is  more  than  the  average  nerv- 
ous system  can  endure.  Only  the  calm  assur- 
ance of  mastery  which  comes  of  thorough  prep- 
aration can  avail  to  carry  one  without  undue 

86 


A  PROPER  STANDARD  OF  SPEECH 

nervous  strain  through  the  arduous,  exacting 
work  of  the  speech  teacher. 

Another  too  frequent  blunder  in  this  field  of 
speech  correction  which  may  be  avoided  by  those 
who  choose  their  instructors  wisely  is  seen  in  bad 
school  management.  It  is,  for  example,  a  great 
mistake  to  employ  a  "  special  teacher  "  to  give  her 
entire  time  to  speech  correction  in  the  schools. 
The  work  is  too  monotonous  for  her  good  and 
her  pupils  are  injured  by  being  temporarily  re- 
moved from  the  grades.  She  loses  contact  with 
the  normal  child  minds  with  which  the  ordinary 
grade  teacher  deals.  The  board  loses  a  grade 
teacher  and  pays  high  for  a  special  teacher. 

All  these  things  are  avoided  by  the  solution 
which  I  propose.  The  "  part-time  teacher  "  con- 
tinues her  grade  work  and  allows  her  speech  pu- 
pils to  remain  in  the  grades.  She  meets  them  for 
a  short  time  after  school.  This  gives  her  variety 
of  work  in  the  place  of  monotony.  The  board 
loses  no  teacher  and  saves  the  expense  of  a  high- 
salaried  specialist  by  raising  the  part-time  teacher's 
salary  a  little  annually.  Thus  there  are  obvious 
advantages  to  pupils,  to  teachers,  and  to  school 
boards  alike. 


SPEECH  IMPROVEMENT  IN  KINDERGARTEN 
AND  ELEMENTARY  GRADES 

Prevention  in  speech  disorders  has  scarcely  yet 
begun.  The  case  is  similar  in  other  fields.  It 
took  modern  medicine  over  one  hundred  years 
to  recognize  prevention  as  its  most  important 
function.  But  why  is  this  ?  The  reason  is  that 
we  see  the  problem,  so  to  speak,  only  in  its  ad- 
vance guard,  and  we  strike  only  at  the  foes  that 
we  see.  It  would  be  better  to  train  our  long- 
range  guns  over  the  first-line  trenches  and  upon 
the  roads  and  centers  of  supply  which  feed  them. 
Diseases  were  first  attacked  by  seeking  some 
method  of  eliminating  them  directly.  It  was  many 
years  afterwards  that  men  sought  to  uproot  the 
origins  of  disease.  In  the  speech  disorder  move- 
ment of  the  present  day  we  have  already  passed 
through  one  or  two  phases.  We  have  seen  the 
problem.  We  have  attacked  the  problem  where 
it  seems  most  obvious,  in  the  years,  namely,  from 
eight  to  sixteen.  Let  us  take  a  warning  from  the 
history  of  medicine  and  initiate  a  program  of 

S8 


KINDERGARTEN  AND  GRADES 

prevention  before  we  are  forced  into  it  by  find- 
ing the  old  program  useless.  Let  us  start  at 
once  on  prevention. 

It  is  hard  to  do  this.  A  school  committee  can 
be  made  to  see  that  speech  defect  should  be  elim- 
inated in  the  sixth,  seventh,  and  eighth  grades. 
There  the  problem  looms  large  enough  to  seem 
worthy  of  an  appropriation  of  funds.  If  we  sug- 
gest, however,  that  the  problem  be  attacked  lower 
down,  on  the  side  of  prevention,  and  advise  that 
the  work  be  initiated  in  the  kindergarten  and 
primary  grades,  nobody  will  be  moved  an  inch  I 
Enlightened  teachers  and  superintendents  should 
do  what  they  can  to  change  this  condition  of 
affairs. 

Ideals  of  prevention,  following  the  aims  of 
medicine,  lead  us  to  start  our  program  of  speech 
reform  in  the  kindergarten.  Dare  I  hint  the  ad- 
visability of  going  still  farther  back }  I  fear  it 
is  n't  quite  time.  I  fear  we  shall  have  to  attack 
the  preventive  problem  in  the  kindergarten  for  a 
few  years  before  it  can  be  generally  realized  that 
still  farther  back  lies  the  real  spring  from  which 
our  speech  disorders  take  their  origin.  Preven- 
tion in  the  home,  then,  will  be  reserved  for  another 
time.  School  managements  may  balk  even  at  this 
suggestion  that  they  make  their  chief  point  of 

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SPEECH  DEFECTS  IN  CHILDREN 

attack  in  the  kindergarten,  but  they  would  cer- 
tainly balk  if  we  tried  to  initiate  any  program  of 
prevention  in  the  homes !  I  see  no  reason,  how- 
ever, why,  five  or  ten  years  from  now,  there 
should  not  be  sent  out  from  the  superintendent's 
office  a  corps  of  visiting  social  workers  to  go  into 
the  homes  of  children  who  are  to  come  into  the 
school  in  a  year  and  give  them,  where  necessary, 
a  year's  instruction  in  speech.  Then  we  should 
naturally  find  the  problem  removed  from  the  kin- 
dergarten to  a  great  extent,  just  as  we  expect  to 
remove  it  from  the  higher  grades,  by  concentrat- 
ing our  attack  upon  the  kindergarten. 

/.  Importance  of  the  child's  speech  environment 

Speech  disorders  in  the  early  grades  tend  to 
make  us  look  backward  to  see  whence  they  have 
come,  not  for  the  sake  of  initiating  any  method 
of  treatment,  not  for  the  sake  of  prevention,  but 
to  get  whatever  information  we  need  for  the  treat- 
ment of  the  cases. 

Imitation  plays  an  important  part,  as  we  have 
already  noticed,  in  the  child's  speech  defects. 
Foreign  accent  in  the  home  is  almost  sure  to  in- 
fluence the  child's  speech  in  school.  Almost  all 
phonetic  defects,  and  very  often  lisping,  have 
their  origin  in  imitation  of  some  one  in  the  home. 

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KINDERGARTEN  AND  GRADES 

That  stuttering  is  often  caused  by  imitation  has 
been  recognized  for  a  long  time.  From  this  it  is 
very  easy  to  come  to  the  final  conclusion  that  the 
speech  environment  in  the  years  that  precede 
the  early  school  years  is  stamped  upon  the  indi- 
vidual in  a  most  permanent  and  lasting  manner. 
The  negative  side  of  a  proposition  is  not  al- 
ways so  interesting  as  the  positive  side.  Early 
environment  does  indeed  cause  speech  defects, 
but  it  can  just  as  easily  set  the  mould  of  speech 
in  the  line  of  perfection  in  all  the  excellences  of 
utterance.  The  ideal  kind  of  speech  environment 
can  impress  itself  just  as  indelibly  upon  the  child 
in  his  earliest  years  as  can  the  faulty  speech  en- 
vironment. It  is  not  our  present  purpose  to  in- 
itiate any  effort  toward  the  establishment  of  a 
speech  environment  conducive  to  elegant  Eng- 
lish upon  entrance  to  the  kindergarten,  although 
this  could  very  easily  be  done.  Social  workers, 
for  example,  could  gather  the  children  together  in 
groups  and  give  them  speech  instruction.  Speech 
environment  may  be  improved  in  numerous  other 
ways.  Night  schools  for  the  parents  would  elimi- 
nate speech  defects  and  mistakes  ingrammar,  and 
thus  improve  the  environment  of  those  still  in 
tender  years.  Older  school  children  bring  their 
speech  standards  back  from  schooland  raise, 

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SPEECH  DEFECTS  IN  CHILDREN 

thereby,  the  general  speech  standard  of  the  whole 
family. 

The  sources  of  our  kindergarten  speech  disor- 
ders are  usually  found  to  lie  in  the  speech  envi- 
ronment of  the  home.  They  may  also  be  due  to 
inherited  mental  deficiency.  Sometimes  they  may 
be  traced  to  some  one  in  the  child's  neighborhood 
outside  the  home.  With  this  knowledge  of  the 
sources  of  early  speech  defects,  we  can  approach 
the  problem  of  their  elimination  with  better  un- 
derstanding. 

2.  Importance  of  the  period  before  speech  begins 

The  mother  listens  for  anxious  months  for  the 
first  word  spoken  by  her  child.  It  is  noted  down 
with  date  and  hour,  and  the  whole  family  is  called 
in  to  hear  it  repeated.  Little  think  they  of  the 
amount  of  culture,  education,  and  training  that 
the  little  one  must  have  passed  through  in  order 
to  perfect  the  first  tiny  utterance.  There  has 
been  a  long  period  of  sensory  registration  of  the 
sounds  in  the  environment.  All  this  time  has 
been  spent  in  listening,  taking  in  sounds,  recall- 
ing them,  impressing  them  upon  the  memory  by 
constant  repetition,  until  finally,  after  a  year  and 
a  half,  the  speech  arc  is  completed  and  one  single 
word  drops  out. 

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KINDERGARTEN  AND  GRADES 

In  this  pre-talking  period  of  sensory  intake  the 
standard  vowel  and  consonant  sounds  should  be 
heard  and  remembered,  the  proper  use  of  the 
speech  organs  should  be  learned.  In  these  early 
years,  also,  exact  and  correct  combinations  of 
vowels  and  consonants  in  words  with  their  cus- 
tomary accent  should  be  heard  and  learned  by 
the  listening  child.  We  cannot  too  strongly  em- 
phasize the  great  desirability  that  the  child  should 
hear  only  perfect  English  in  these  years.  If  we 
would  have  a  correct  and  ideal  utterance  when 
speech  begins  we  can  obtain  it  only  by  the  influ- 
ences and  the  environment  of  speech  which  we 
cast  about  the  child  in  his  listening  years. 

Montessori  mothers  allow  their  children  perfect 
freedom  in  the  repetition  of  any  speech  mistakes 
they  may  hear,  just  as  they  allow  them  bad  table 
manners  and  unwarranted  freedom  on  the  street. 
The  idea  is  that  they  should  not  be  thwarted  but 
should  be  allowed  to  grow  out  of  their  slovenly 
ways.  This  whole  idea  is  absolutely  out  of  har- 
mony with  acknowledged  psychological  principles 
of  growth.  It  is  just  as  easy  to  begin  with  cor- 
rect as  with  incorrect  models.  The  child  should 
be  shown  at  the  start  the  correct  and  customary 
utterance,  act,  or  liberty,  with  the  best  technique 
possible  in  its  accomplishment.  The  growing  child 

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SPEECH  DEFECTS  IN  CHILDREN 

should  never  hear  phonetic  defects,  imperfect 
vowels  and  bad  grammar  or  slang,  consonants, 
stuttering,  or  any  speech  disorders  whatsoever. 
If  it  does,  utterance  of  the  thing  taken  in  is  to 
be  expected.  If  it  hears  only  perfect  English, 
perfect  grammar,  its  utterances  reach  those  ideals 
of  English  pronunciation  which  otherwise  take  so 
long  to  instill. 

J.  The  earliest  utterances — source ^  form, 
significance 

The  baby's  first  word  has  numerous  interest- 
ing phases.  There  is  a  whole  psychology  and  an 
interesting  anatomy  hidden  away  behind  that  sim- 
ple utterance.  The  earliest  word  may  be  studied 
under  three  aspects  :  the  source,  the  form  of  ut- 
terance, and  the  significance. 

The  source  of  the  first  word  is  usually  found 
in  some  phrase,  name,  or  single  monosyllable  fre- 
quently heard  by  the  child.  The  name  of  the 
dog,  of  the  father  or  mother,  of  another  child, 
or  some  very  frequently  used  phrase,  like  "  Oh, 
my,"  "Oh,  dear,"  sometimes  even  an  oath,  may 
be  the  first  utterance  of  the  infant.  This  oft- 
repeated  word  may  be  caught  up  from  the  other 
children.  Rarely  is  it  marked  by  a  speech  defect, 
and,  if  it  is,  it  is  one  that  is  frequently  repeated  in 

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KINDERGARTEN  AND  GRADES 

the  family,  has  been  drummed  in  for  months  and 
months,  and  by  thousands  of  repetitions.  First 
words  are  rarely  if  ever  long  ones,  they  are  usu- 
ally monosyllables,  they  are  usually  names.  Al- 
most always  they  are  sound  repetitions. 

Knowledge  of  the  sources  of  early  utterances 
helps  in  tracing  speech  disorders,  and  in  the  treat- 
ment of  them.  If  the  first  incorrect  utterance  is 
due  to  a  thousand  repetitions  of  it  in  the  child's 
hearing,  it  might  be  curable  by  a  thousand  repeti- 
tions in  his  hearing  of  the  correct  pronunciation. 

I  have  heard  it  stated  that  children  never  use 
abstract  terms,  and  rarely  use  adjectives.  But 
forms  of  first  words  take  no  definite  shape.  Some 
think  that  they  should  be  names,  others  that  they 
should  be  words  of  motion,  but  this  is  not  at  all 
so.  The  form  then  is  entirely  immaterial. 

The  choice  of  the  first  word  is  determined  by 
what  has  been  most  commonly  uttered  in  the 
presence  of  the  child,  be  it  noun,  adjective,  ab- 
stract word,  or  what  not.  It  does  not  signify 
that  we  begin  our  thinking  with  nouns,  or  with 
words  of  motion. 

Significance  in  the  utterances  of  the  year-old 
or  two-year-old  child  is  minimal.  It  cannot  lead 
us  to  any  very  profound  psychological  generaliza- 
tions.   The  child's  first  word  signifies  that  the 

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SPEECH  DEFECTS  IN  CHILDREN 

speech  arc  is  completed,  that  a  certain  definite 
sound  has  been  registered,  that  some  simple  col- 
laborative process  has  been  carried  on  upon  that 
registration,  and  that  finally  it  has  been  exactly 
taken  over  and  put  out  through  the  motor  area 
with  such  exactness  that  it  can  be  recognized  and 
traced  to  an  old  environmental  utterance  long 
and  often  repeated. 

Observations  on  first  words  give  us  an  inkling 
into  the  origin  of  speech.  They  let  us  see  how 
long  and  frequently  the  first  word  had  to  be  heard 
before  it  was  put  forth.  Let  the  teacher  of  speech 
disorders  take  courage  when  she  finds  that  she 
cannot  correct  an  imitated  lisp  in  a  week.  It  took 
a  year  and  a  half  to  instill  that  lisp  and,  perhaps, 
following  that,  there  have  been  two  or  three  years 
of  repetition. 

4.  Simple  speech — how  to  amplify  it 

Passing  the  early  years  of  speech  beginnings, 
we  come  to  a  consideration  of  somewhat  more 
complicated  utterances,  those  that  we  are  likely 
to  find  in  the  kindergarten.  Here  the  important 
thing  is  to  amplify  speech,  to  make  it  evolve,  to 
encourage  it,  and  to  keep  it  to  its  proper  standard. 

Simple  speech  includes  mostly  names,  a  few 
adjectives,  few  difficult  connecting  words,  simple 

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KINDERGARTEN  AND  GRADES 

sentences.  All  these  have  their  origins  in  words 
picked  up  at  home.  The  whole  infantile  vocabu- 
lary is  nothing  but  an  echo  of  the  home  vocabu- 
lary. 

Amplification  of  simple  speech  should  take 
three  directions  :  repetition,  application,  and  addi- 
tion of  new  words.  If  these  three  methods  are 
undertaken  and  carried  forward,  the  speech  al- 
ready attained  is  at  once  deepened  and  amplified. 

Repetition  of  old  utterances.  When  the  child 
hears  his  own  words  repeated  by  another  person, 
he  gains  confidence  because  he  sees  that  his  utter- 
ances are  understood  and  that  he  has  made  his 
point.  Intimacy  and  confidence,  friendship  and 
mutual  understanding,  are  insured  between  the 
child  and  the  teacher  by  the  teacher's  repetition 
of  the  child's  own  words.  I  have  seen  a  mother 
try  always  to  give  her  child  some  new  phrases  in 
answer  to  its  words,  the  result  being  confusion, 
coldness,  and  misunderstanding  on  the  part  of 
the  little  one.  Never  hearing  its  own  words  re- 
peated, it  never  felt  that  its  own  words  had  got 
across  into  the  mind  of  another. 

Application  of  old  words  to  new  situations  is 
another  means  of  encouraging  and  amplifying 
speech.  The  child  should  be  told,  in  the  words 
he  already  knows,  to  do  certain  things.  Obedi- 

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SPEECH  DEFECTS  IN  CHILDREN 

ence  signifies  that  the  meaning  of  the  words  has 
been  understood.  AppHcation  of  the  child's  vo- 
cabulary in  this  way  deepens  the  impression  of 
the  words  he  is  familiar  with  and  makes  them 
less  easily  forgotten. 

Addition  of  new  words  is  our  third  method  of 
simple  speech  amplification.  New  terms  should 
be  taught  by  illustrating  their  use.  The  child 
should  be  shown  a  given  object  repeatedly,  be- 
fore any  word  is  uttered.  Then  the  name  of  the 
object  should  be  given  and  repeated.  Next  the 
child  should  be  told  to  use  the  object  named  in 
some  definite  manner.  In  this  way  the  word  is 
kept  before  the  child's  mind  for  some  time.  Fi- 
nally, the  child's  registration  of  the  new  word 
should  be  tested  by  asking  him  to  name  the  ob- 
ject. If  the  previous  steps  have  been  properly 
taken,  the  name  will  be  immediately  forthcoming. 

In  a  word,  then,  the  steps  for  acquisition  of  a 
new  vocabulary  should  be  sensory  presentation 
of  object,  followed  by  repetition;  secondly,  name 
of  the  object,  followed  by  repetition  ;  thirdly,  use 
of  the  object,  also  repeated  ;  fourthly,  request  to 
produce  the  name  of  the  object  at  sight.  These 
simple  steps  may  be  seen  to  be  the  logical  series 
through  which  learning  processes  pass.  They 
have  an  anatomical  basis,  a  physiological  back- 

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KINDERGARTEN  AND  GRADES 

ground,  and  a  psychological  foundation,  that  make 
just  these  steps  and  in  this  series  proper  and 
necessary. 

Hints  like  these  as  to  the  beginnings  of  normal 
speech  cannot  but  serve  the  teacher  in  dealing 
with  speech  disorders  by  thus  giving  her  an  in- 
sight into  the  nerve  series,  the  physiology,  and 
the  psychology  of  early  speech.  When  one  sees 
that  the  normal  learning  of  words  takes  so  much 
time  and  so  many  repetitions,  it  becomes  clear 
why  the  installation  of  a  perfect  utterance  to  re- 
place an  imperfect  one  must  needs  require  an 
equal  amount  of  persistency  and  repetition. 

5.  Delayed  speech  and  its  causes 

Study  of  early  normal  utterance  offers  many 
points  of  departure  for  attack  upon  speech  dis- 
order in  the  kindergarten  and  the  early  grades. 
For  that  reason  it  has  been  treated  somewhat  at 
length,  but  it  is  time  now  to  turn  to  our  more 
immediate  subject  and  to  deal  with  some  of  the 
most  common  disorders  found  among  children 
from  two  to  five  years  of  age. 

Delayed  speech  is  one  of  the  most  frequent 
deviations  from  the  evolution  of  normal  talking. 
By  "  delayed  speech  "  I  do  not  refer  to  a  defi- 
ciency caused  by  feeble-mindedness ;  I  assume  a 

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SPEECH  DEFECTS  IN  CHILDREN 

normal  brain  background.  Delay  in  speech  is 
mostly  due  to  environment.  It  is  found  in  the 
silent  home  where  the  parents  talk  little  to  the 
baby  and  little  to  each  other.  It  results  where 
the  baby  is  set  down  for  many  hours  alone.  It 
may  also  result  from  great  speed  of  conversation, 
with  little  effort  to  utter  individual  words  dis- 
tinctly, to  use  small  words,  or  to  name  things  to 
the  baby. 

All  this  is  quite  natural.  The  same  thing  oc- 
curs with  the  eye.  Where  the  stimuli  are  absent 
the  function  fails  to  evolve.  Touch  and  discrimi- 
nations of  touch  are  atrophied  similarly  through 
lack  of  use.  Delayed  speech  is  really  undeveloped 
because  unstimulated  speech. 

Treatment  of  normal  children  who  are  backward 
in  speech  development  consists  in  encouraging 
the  child  by  going  through  the  steps  mentioned 
above  in  treating  the  development  of  simple  speech. 

6.  Early  speech  defects  and  what  they  lead  to 

The  defects  observed  in  kindergarten  are  most 
frequently  not  quite  the  defects  that  appear  later. 
Consonants  are  likely  to  be  slightly  off  the  stand- 
ard. Words  are  sometimes  mispronounced.  Syl- 
lables are  omitted.  Grammar  is  wrong.  All  these 
minor  matters  are  less  defects  than  imperfections. 

I  GO 


KINDERGARTEN  AND  GRADES 

They  show  an  effort  at  producing  what  has  been 
heard,  but  the  output  is  a  Httle  incomplete. 

Minor  matters  Hke  these  may  be  massed  to- 
gether and  treated  by  constant  repetition  of  the 
correct  forms.  When,  however,  one  comes  upon 
such  things  as  Hsping  and  the  absence  of  conso- 
nants, he  should  realize  the  presence  of  a  real 
defect  likely  to  lead  to  a  permanent  disorder. 
One's  chief  reliance,  during  these  early  years,  in 
correcting  defects,  should  be  more  than  anything 
else  upon  imitation  in  sound.  The  ear  of  the 
normal  child  is  very  acute.  It  quickly  apprehends 
the  difference  between  a  correct  utterance  and 
its  own  faulty  pronunciation ;  it  has  the  faculty 
of  trying  this  and  that  sound  until,  by  experi- 
ment, it  hits  upon  the  correct  utterance.  There- 
fore, one  should  begin  with  the  faculty  of  imita- 
tion and  resort  to  detailed  instruction  as  to  mouth 
positions  only  after  it  has  failed.  Any  one  can 
see  that  instructions  about  mouth  position  are 
uninteresting  to  little  people.  They  should,  there- 
fore, be  used  only  as  a  last  resort. 

It  is  easy  to  advise  the  use  of  the  imitative 
faculty.  What  one  should  know  about  the  method 
in  teaching  is  more  complicated  than  at  first  ap- 
pears. An  analysis  of  imitation  and  its  processes 
resolves  the  method  into  a  systematic  develop- 

lOI 


SPEECH  DEFECTS  IN  CHILDREN 

ment  of  hearing,  a  continuous  drill  of  sound  rep- 
etitions, and  a  building-up  of  brain  cortical  areas 
that  differentiate  between  different  sounds.  So 
that  in  the  pedagogical  use  of  imitation  we  must 
have  not  only  a  way  of  developing  sensory  per- 
ception, but  a  method  of  developing  the  recollec- 
tion and  interpretation  of  stimuli,  together  with 
more  or  less  collaboration  upon  them..  There 
must  also  be  an  attempt  to  correlate  the  external 
speech  mechanism  with  all  this  new  mental  ac- 
quisition. This  can  be  accomplished  only  by  nu- 
merous guesses,  miscalculations,  and  trials,  until 
finally  the  heard,  registered,  and  remembered  sen- 
sation is  uttered  as  heard.  Many  infantile  speech 
disorders  may  be  very  quickly  corrected  if  their 
treatment  is  made  into  a  game  and  the  child  is 
rewarded  for  attaining  the  desired  end. 

Exact  position  cobrdifiation  in  the  mouth  may 
be  resorted  to  if  the  above  attempt  fails.  When 
this  method  is  undertaken,  the  first  sounds  to  be 
taught  are  those  that  are  made  in  the  front  of 
the  mouth,  such  as  m,  p,  and  b.  Then  take  up 
those  that  are  made  a  little  farther  back  in  the 
mouth:  ;/,  ^,  and  d.  S,  /,  and  r  may  naturally 
follow,  or  they  may  be  preceded  by  n^;  k,  and  ^. 
Then  the  order  matters  little :  s/i,  cA,  ^,  tk.  Some 
of  these  back  sounds  are  difficult  to  teach.  They 

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KINDERGARTEN  AND  GRADES 

can  be  acquired  easily  by  imitation.  To  teach  the 
front  sounds  is  sometimes  quite  easy,  sometimes 
quite  difficult. 

Stuttering  in  the  early  years  is  unusual.  Some- 
times it  may  be  eliminated  by  proper  rest  and 
hygiene ;  more  often  it  may  be  cured  by  change 
of  mental  environment  for  two  or  three  months ; 
sometimes  it  may  be  eradicated  by  creating  a 
more  genial  atmosphere  in  the  home  so  that  the 
child's  mental  processes  are  not  interfered  with. 
Aside  from  these  attempts  at  individual  treat- 
ment, the  same  visualization  processes  should  be 
inaugurated  in  the  kindergarten  that  were  men- 
tioned above  for  older  children. 

Delayed  ^mentality  may  have  an  associated 
speech  retardation.  The  speech  of  the  idiot,  the 
imbecile,  or  the  moron  makes  their  diagnosis  by 
the  expert  a  very  easy  matter.  If  of  low  grade 
and  with  marked  speech  defect,  they  are  institu- 
tional cases  and  should  be  removed.  If  of  the 
middle  grade,  with  mild  speech  defect,  they 
should  be  consigned  to  the  special  class  where 
mental  defectives  are  gladly  received.  If  on  the 
other  hand  they  are  slightly  lacking  in  mentality, 
they  may  be  retained,  and  final  disposition  made  of 
them  later  in  the  grades,  when  their  capacity  for 
progress  has  been  more  definitely  determined. 

103 


SPEECH  DEFECTS  IN  CHILDREN 

7.  Special  methods  in  individual  cases 

It  is  hard  to  give  general  rules  that  can  be 
applied  automatically  to  individual  cases.  The 
teacher's  information  should  be  sufficiently  wide 
and  diverse  to  enable  her  to  deal  intelligently 
with  individual  cases  as  they  arise.  It  will  be  well, 
however,  to  discuss  here  one  or  two  special  cases. 

Excessive  haste  in  speech  is  simply  one  phase 
of  great  mental  activity  which  overflows  also  in 
excessive  bodily  motions  and  in  constant  twitch- 
ings.  This  great  speed  of  utterance  requires  spe- 
cial care.  In  this  special  type  of  speech  defect, 
insistence  on  slow  utterance,  modulated  expres- 
sion, and  the  production  of  exact  sounds  with  a 
long  breath,  brings  out  the  proper  enunciations 
almost  every  time.  This  makes  it  clear  that  we 
are  not  dealing  in  this  case  with  defective  pronun- 
ciation. The  whole  fault  lies  in  the  excess  of 
speed.  Another  approach  to  the  cure  of  such 
cases  is  needed.  Experience  shows  that  the  use 
of  a  series  of  slow,  controlled,  evenly  executed, 
gymnastic  movements  results  in  almost  immedi- 
ate improvem.ent.  These  cases  should  be  put 
through  a  system  of  calisthenics  of  this  sort,  be- 
ing made  to  practice  for  fifteen  minutes  three 
times  a  day,  for  two  or  three  months.  I  have 

104 


KINDERGARTEN  AND  GRADES 

seen  cases  that  have  been  cured  almost  entirely 
by  this  simple  procedure,  with  hardly  a  reference 
to  the  external  speech  mechanism  and  with  no 
hint  of  imitation. 

Other  puzzling  cases  are  somewhat  like  the 
following  one  ;  A  case  of  marked  phonetic  defect 
appeared.  The  defects  were  numerous.  It  was 
found  that  clear  English  was  spoken  in  the  fam- 
ily. The  ear  was  suspected  as  the  seat  of  the 
trouble.  When  the  ear  was  examined  —  and  I  re- 
fer here  to  the  mental  ear,  like  the  mind's  eye  — 
several  marked  defects  showed  up.  The  child 
could  not  sing  the  scale  or  appreciate  tones,  har- 
monies, and  melodies,  and  there  was  no  ability  to 
differentiate  between  two  notes. 

This  may  illustrate  some  of  the  most  puzzling 
cases  that  a  teacher  is  called  upon  to  undertake, 
and  it  may  open  the  way  to  curative  methods 
which  should  be  applied  primarily  to  the  ear 
rather  than  to  the  talking  apparatus  at  the  other 
end  of  speech. 

The  method  of  procedure  in  a  case  like  this  is 
to  train  the  ear,  first  to  sounds  with  large  differ- 
ences, then  to  sounds  with  smaller  and  smaller 
differences.  The  varieties  of  sound  here  referred 
to  should  be  varieties  in  pitch,  intensity,  vowel 
form,  and  consonant  execution.   Phonetic  ear  de- 


SPEECH  DEFECTS  IN  CHILDREN 

fects  last  a  long  while;  one  may  [have  to  train 
a  case  of  this  sort  for  a  year  or  two,  but  such 
training  is  the  only  method  by  which  a  proper 
nervous  output  can  be  attained.  This  long,  tedi- 
ous drill  is  profitable,  however,  in  other  ways.  It 
enables  the  patient  to  stand  higher  in  spelling  and 
writing  and  in  school  music  than  would  be  pos- 
sible under  other  circumstances. 

One  might  cite  innumerable  complicated  cases, 
such  as  these.  Every  case  differs  from  every 
other.  Let  what  has  been  said  suffice  to  show 
that  numerous  methods  have  to  be  resorted  to 
in  order  to  build  up  the  background  of  perfect 
speech. 

8.  Danger  of  leaving  defects  to  he  "  outgrown  " 

Criticism  is  rife  in  these  days.  Many  people 
are  willing  to  criticize  but  few  are  willing  to 
do  actual  work  in  eliminating  speech  disorders. 
Criticisms  of  speech  instruction  are  numerous  in 
their  forms  and  their  follies.  From  among  them 
all,  I  have  chosen  one  that  will  often  come  up  in 
discussions  of  the  school  curriculum  and  which 
may  frequently  be  offered  even  by  the  physician. 
Many  people  say  :  "  Leave  the  case  alone  and  it 
will  outgrow  its  defect."  No  treatment  could  be 
more  foolish  than  this.   No  advice  could  be  more 

io6 


KINDERGARTEN  AND  GRADES 

ill-advised ;  no  suggestion  could  show  more  ig- 
norance of  the  problems  of  speech.  Such  advisers 
are  ignorant  of  the  harm  they  are  doing  and  of 
the  amount  of  mental  drill  of  which  they  are 
depriving  the  pupil.  Nor  do  they  know  at  all 
whether  or  not  these  cases  will  ever  "outgrow  " 
their  defects.  In  brief,  this  advice  is  without 
foundation,  without  scientific  backing,  and  should 
never  be  followed.  It  really  means,  "  I  don't 
know,"  and  should  always  be  so  translated. 
Granted  that  a  few  defects  are  outgrown.  They 
would  have  been  overcome  more  quickly  and 
would  have  acquired  greater  speech  excellence 
under  training  than  by  leaving  the  matter  to  time. 
Moreover,  no  one  knows  whether  a  given  defect, 
as  seen  in  a  child,  will  be  outgrown  or  not. 

p.  How  to  raise  the  speech  standard  in  the 
classroom 

Individual  methods  of  attack  have  been  de- 
scribed in  some  detail,  but  there  are  still  other 
ways  in  which  the  general  level  of  speech  excel- 
lence can  be  improved  throughout  a  kindergarten 
class  as  well  as  in  the  elementary  grades.  I  would 
advise  that  the  class  be  put  through  a  daily  or 
perhaps  twice  daily  series  of  vocal  drills  in  unison. 
This  trains  the  ear,  improves  the  memory  for 

107 


SPEECH  DEFECTS  IN  CHILDREN 

sound,  and  gives  a  little  enunciation  drill.  It 
gives  the  class  a  sort  of  stability  and  unity, 
as  music  does,  and  sets  a  vocal  standard  that 
is  apt  to  be  imitated  and  followed  by  all  the 
members. 

Programs  for  such  exercises  might  be  outlined 
somewhat  as  follows  : 

Exercise  i.  Ah,  a,  e,  aw,  o,  oo.  Directions:  Repeat 
this  series  of  vowels  one  after  the  other  in  the  order 
given,  on  three  notes  of  the  scale. 

Exercise  2.  Ah,  a,  e,  aw,  0,  00.  Directions:  Re- 
peat in  series  as  above  going  up  the  scale  and  down 
on  each  vowel. 

Exercise  j.  Ah,  a,  e,  aw,  0,  00.  Directions:  Repeat 
each  vowel  with  a  modulation  of  intensity.  That 
is,  begin  very  lightly,  increase  the  intensity  to  the 
maximum,  and  then  gradually  return  to  the  original 
lightness  and  softness  again.  Do  this  on  each  vowel. 

Exercise  4.  Repeat  the  words,  "Papa,  obey  me" 
—  "to  dinner"  —  "cow  going."  Directions:  Re- 
peat the  directions  that  are  given  under  Exercise  i. 
This  will  give  a  drill  on  the  nine  consonants  and  also 
allow  for  the  use  of  the  vowels  in  the  above  series  at 
the  same  time. 

Other  exercises  might  be  as  follows,  to  include  prac- 
tice on  all  the  consonant  sounds.  Copious  prepro- 
nunciation  by  the  teacher  is  necessary.  Also  much 
individual  drill.  The  grouping  may  be  made  ac- 
cording as  each  teacher  may  fancy. 

108 


KINDERGARTEN  AND  GRADES 


CONSONANT   PRACTICE   LIST 

p pa ap pat paper 

b ba ab bat baby 

.  mat tame 

t ta at tan taper 


> pa 

> ba 

a ma . . . 

•  ••ap 

....ab 

....  am 

ta 

I da.... 

I na. . . . 

at 

....ad 

. , . .an 

: ka.... 

-...ak 

d da ad dog duty 

n na an Nan tan 

k ka ak kite kitty 

g. ga ag gone gutter 

ng nga ang angst ring 

sh sha ash shall ashes 

ch cha ach chat church 

z za az buzz fuzzy 

1 la al let bell 

r ra are run roar 

s se es seen saucy 

f fa af fat after 

V va av vat have 

th tha ath thin with 

h ha ah hat heater 

wh wha white what wa-wa 

w wa aw . water we 

j-dz ja aj jump judge 

10,    Value  of  correct  early  standards 

The  value  of  ideal  standards  to  start  with  can 
hardly  be  over-estimated.  They  cannot  be  esti- 
mated at  all  by  those  who  take  the  narrow  view 
of  speech  defects.  Their  value  is  appreciated  only 
by  those  who  hold  the  tenet,  "  The  boy  is  father 
to  the  man,"  or,  as  Pope  puts  it,  "As  the  twig  is 
bent  the  tree  's  inclined." 

109 


SPEECH  DEFECTS  IN  CHILDREN 

This  matter  has  been  mentioned  repeatedly  in 
these  pages,  because  it  deserves  repetition.  The 
special  teacher  of  speech  improvement  can  do 
nothing  better  than  to  implant  proper  standards 
early,  to  place  the  young  mind  in  the  correct 
paths  and  keep  it  there  until  it  follows  them 
habitually,  never  allowing  any  lax  and  slovenly 
relapse,  a  la  Montessori,  with  the  hope  that  early 
faults  are  easily  outgrown. 

Correct  early  standards  at  once  set  the  young 
mind  in  the  right  path.  Their  repetition  and  en- 
forcement keep  it  there  until  it  chooses  for  itself 
what  is  ultimately  and  permanently  right. 

Correct  early  standards  relieve  the  teacher  of 
much  later  patchwork.  They  instill  a  better  dis- 
cipline in  the  class.  They  give  an  atmosphere  to 
a  schoolroom  which  a  superintendent  feels  im- 
mediately on  his  arrival,  which  conquers  and  per- 
vades and  guides  the  newcomer  into  the  class, 
which  visiting  teachers  admire,  and  which  is  a 
comfort  and  a  relief  to  the  teacher  herself  who 
has  charge  of  the  room. 


VI 


SPEECH  DISORDERS  AMONG  ABNORMAL 
CHILDREN  AND  HOW  TO  TREAT  THEM 

In  recent  years  we  have  discovered  i  the  possi- 
bility of  improving  the  speech  of  the  mentally  de- 
fective —  the  idiot,  the  imbecile,  the  moron,  and 
the  mental  defective  generally.  These  backward 
members  of  the  school  grades  who  are  relegated 
to  so-called  "  special  classes  "  for  instruction  suited 
to  their  peculiar  needs,  these  deficient  mentalities, 
have  lately  been  approached  phonetically  and  vo- 
cally by  a  new  method  of  drill  with  surprisingly 
good  results.  One  mental  expert  has  said  that 
these  individuals  should  derive  as  much  benefit 
from  the  right  sort  of  vocal  drill  as  they  have 
from  the  industrial  drill  already  so  successfully  in 
use.  My  own  experience  has  convinced  me  that 
even  more  is  possible. 

/.  Speech  forms  among  the  feeble-minded 

Although  the  speech   externalization  of  the 
feeble-minded  is  extremely  various,  it  is  possible 

*  This  discovery  was  first  published  in  an  article  as  follows: 
By  Walter  B.  Swift.  "  The  Development  of  a  Mental  Defec- 
tive by  Vocal  Drill,"  Boston  Medical  and  Surgical  Journal^  vol. 
CLXXiii,  no.  20,  pp.  745,  746,  November  11,  1915. 

Ill 


SPEECH  DEFECTS  IN  CHILDREN 

to  devise  a  rough  classification  sufficient  for  prac- 
tical purposes.  Such  a  classification  would  divide 
speech  forms  among  the  feeble-minded  into  three 
classes  :  marked,  medium,  and  mild. 

Marked  feeble-mindedness  shows  itself  in  forms 
of  speech  very  deficient  for  the  age  of  the  indi- 
vidual in  whom  they  are  found.  One  finds  chil- 
dren, for  example,  and  even  adults,  who  can  utter 
only  a  few  words,  or  possibly  none.  In  general, 
the  speech  may  be  described  as  monosyllabic  and 
limited  to  a  very  few  words.  This  is  the  speech 
condition  of  the  idiot. 

Medium  feeble-mindedness  presents  a  speech 
condition  somewhat  more  developed.  Imbecile 
speech  usually  comprises  a  number  of  monosyl- 
labic words  in  addition  to  a  good  many  short  sen- 
tences. No  very  complicated  mental  conception 
is  possible  to  the  imbecile,  however,  and  ac- 
cordingly the  long  and  intricate  sentence  is  not 
found. 

Mild  feeble-mindedness  is  characterized  by 
speech  often  scarcely  distinguishable  from  that 
of  normal  individuals.  Speech  intake  and  speech 
output  areas  may  be  fairly  well  developed.  The 
moron  can  repeat  what  he  has  heard  and  is  some- 
times able  to  make  a  good  impression  in  conver- 
sation.   He  fails,  however,  in  the  collaborative 

112 


ABNORMAL  CHILDREN 

processes  —  complicated  thinking,  deep  compre- 
hension, complex  reasoning. 

2,    Speech  m  the  mental  defective 

By  the  term  '*  mental  defective,"  used  in  con- 
tradistinction to  the  three  terms  employed  above, 
I  here  refer  to  the  individual  with  special  and 
minor  defect.  Where  the  sense  of  hearing  is 
lacking,  for  example,  or  the  ability  to  interpret 
sounds  that  are  heard,  the  sensory  defect  may 
prevent  proper  utterance.  A  defect  of  the  eye 
preventing  correct  registration  of  sight  sensa- 
tions and  the  making  of  correct  visual  images 
may  cause  another  form  of  speech  disorder  which 
externalizes  itself  in  interrupted  or  pumped  con- 
versation. Again,  a  moral  defect  may  cause  the 
speech  to  be  harsh,  rasping,  and  hasty. 

J.   The  basis  of  abnormal  speech 

No  doubt  there  is  always  a  pathological  back- 
ground for  defects  of  speech,  but  the  study  of 
these  is  of  little  value  for  the  teacher.  Pathology 
of  the  brain  can  be  studied  only  in  the  dead  sub- 
ject. After  one  knows  the  dead  case  well,  he 
cannot  be  certain  that  another  subject,  still  liv- 
ing, is  exactly  like  it.    Accordingly,  he  cannot 

"3 


SPEECH  DEFECTS  IN  CHILDREN 

proceed  from  exact  pathological  findings  to  exact 
educational  methods.  In  education,  however,  we 
deal  with  the  living  individual  and  can  instill  and 
develop  absent  functions.  If  we  knew  much  more 
than  we  do  about  the  brain  pathology  causing  de- 
fective speech,  that  knowledge  would  be  of  little 
practical  service,  except,  perhaps,  that  it  might 
cause  us  to  proceed  more  energetically  with  our 
educational  processes,  forcing  the  development 
of  functions  in  localized  brain  areas  whose  pres- 
ence we  might  suspect. 

That  the  study  of  function  alone  is  often  suf- 
ficient may  be  illustrated  by  a  certain  investiga- 
tion which  I  once  made  in  a  Berlin  laboratory.  I 
was  engaged  in  studying  a  dog  that  could  not 
differentiate  between  two  tones.  On  the  basis  of 
this  lack  of  function  I  maintained  that  the  fibers 
and  cells  which  should  have  performed  that  func- 
tion had  been  extirpated.  My  critics  objected 
that  this  assertion  could  be  proved  only  by  au- 
topsy. The  professor  under  whom  I  was  work- 
ing answered  that  the  functional  absence  was 
sufficient  proof  upon  which  to  base  the  assertion 
of  pathological  absence.  Just  so,  functional  ab- 
sence in  abnormal  speech  is  a  sufficient  basis  upon 
which  to  build  a  system  of  phonetic  training. 


114 


ABNORMAL  CHILDREN 

^.  Normal  phonetics  not  suited  to  treattnent  of 
abnormal  minds 

In  the  early  days,  all  abnormal  mentalities 
were  treated  in  the  regular  grades  of  the  schools, 
it  being  thought  that  they  would  improve  under 
the  same  kind  of  instruction  that  was  given  to 
normal  children.  The  result  was  a  retardation  of 
the  classes  in  which  they  were  found  —  a  retar- 
dation that  increased  as  they  passed  farther  along 
in  the  grades  until  it  became  intolerable  and  the 
school  authorities  concluded  that  the  methods  of 
education  for  normal  and  for  abnormal  children 
would  have  to  be  differentiated.  From  this  con- 
clusion sprang  the  special  classes.  Their  persist- 
ence and  existence  to-day  show  the  correctness 
of  that  conclusion. 

The  original  situation  exists  to-day,  however, 
in  the  meager  approaches  to  the  speech  disorder 
problem  attempted  by  vocal  teachers  in  the  pub- 
lic schools.  They  began  by  the  imposition  upon 
abnormal  minds  of  a  phonetic  treatment  adapted 
only  to  normal  minds.  Their  lesson  has  not  yet 
been  learned.  The  lesson  is  that  ordinary  pho- 
netics is  no  more  applicable  to  abnormal  minds 
than  our  ordinary  school  curriculum  is  applicable 
to  abnormal  minds. 

115 


SPEECH  DEFECTS  IN  CHILDREN 

The  regular  grade  work,  suited  to  the  normal 
child,  has  been  replaced  by  industrial  drill  for  the 
abnormal  child.  Why,  then,  should  we  expect 
that  phonetics  intended  for  normal  children  will 
serve  just  as  well  for  the  abnormal  ?  The  differ- 
ence between  phonetics  for  the  normal  and  pho- 
netics for  the  abnormal  should  be  as  great  as  that 
between  the  ordinary  grade  school  curriculum 
and  industrial  drill. 

Understanding  of  this  matter  explains  many 
apparent  failures  in  the  vocal  training  of  abnor- 
mal children.  I  have  repeatedly  heard  teachers 
say :  **  I  teach  the  boy  to  pronounce  a  sound 
correctly,  and  then  the  next  day  he  has  forgotten 
all  about  it.  I  have  done  this  over  and  over,  and 
have  come  to  the  conclusion  that  it  is  impossible 
to  teach  him  proper  pronunciation."  The  diffi- 
culty is  that  the  wrong  sort  of  drill  has  been 
applied. 

5.    Mental  background  assumed  in  normal 
phonetics 

For  the  sake  of  contrast,  it  will  be  well  to  say 
a  word  about  the  psychological  background  of 
speech  in  normal  minds.  Normal  speech  sub- 
sumes a  series  of  normal  nerve  functions.  The 
sensory  intake  areas  of  the  brain  —  those  of  eye, 

116 


ABNORMAL  CHILDREN 

ear,  mouth,  feeling  —  are  all  intact.  Above  these 
are  adequately  developed  sensory  word  combina- 
tions, psychic  seeing,  position  sense,  and  inter- 
pretation areas.  Still  higher,  there  are  normal 
collaborative  processes,  such  as  imagination,  mera 
ory,  reason,  visual  recall.  On  the  motor  side  are 
the  higher  motor  control  areas,  which  by  certain 
delicate  motor  processes  control  the  lower  motor 
output  areas  and  result  externally  in  speech. 
This  is  the  whole  round  of  the  speech  mechan- 
ism. The  functions  of  all  these  areas  compose 
the  mental  background  that  we  assume  in  normal 
phonetics. 

6.  Actual  mental  backgrounds  in  abnormal  minds 

The  contrasts  here  are  extreme.  Abnormal 
minds  present  lack  of  function  in  any  or  all  of 
the  different  parts  of  the  speech  mechanism  just 
mentioned.  For  example,  there  may  be  faulty, 
or  even  absent,  sensory  intake  in  the  lowest  type 
of  idiocy.  In  imbecility  there  may  be  fairly  good 
intake,  with  no  functional  interpretation.  In  the 
moron,  there  may  be  deficient  collaborative  proc- 
esses - —  reasoning,  comprehension,  imagination. 
The  motor  output  side  may  correspondingly  lack 
because  the  sensory  side  cannot  furnish  enough 
stimuli  for  its  growth.    These  functional  defi' 

117 


SPEECH  DEFECTS  IN  CHILDREN 

ciencies  may  depend  upon  pathological  deficiency 
or  absence  of  fibers  and  cells  of  the  cortex.  This, 
however,  is  not  the  present  question. 

Phonetics  for  the  abnormal,  following  the  ex- 
ample of  industrial  drill,  should  begin  with  those 
functions  which  the  abnormal  mind  actually  pos- 
sesses. There  should  be  a  means  of  ascertaining 
just  what  these  functional  activities  are  and  just 
what  the  vocal  capabilities  of  the  individual  under 
treatment  actually  are,  no  matter  how  simple 
these  may  be. 

After  the  mental  level  has  been  discovered, 
the  procedure  should  not  be  rapid  or  difficult.  I 
begin  my  own  cases  by  drilling  them  a  long  time 
upon  those  things  which  they  can  already  do,  be- 
fore passing  to  the  development  of  functions 
which  examination  has  shown  to  be  absent.  We 
have  to  build  upon  what  a  man  can  do,  no  matter 
how  little  that  is,  until  the  function  in  question 
enlarges  of  itself  its  own  scope  of  activity —  shows 
in  its  speed  and  variety  of  action  that  it  has  taken 
on  new  powers  and  new  capabilities.  Then,  and 
not  till  then,  should  the  training  be  carried  far- 
ther. The  whole  procedure  should  be  carried  on 
in  this  way,  step  by  step. 


iiS 


ABNORMAL  CHILDREN 

7.  Physiological  basis  for  the  treatment  of 
mental  defectives 

Nature  never  presses  little  children  beyond 
their  capabilities.  In  their  first  years,  they  reach 
for  and  touch  things  and  take  in  gross  sensations. 
Later,  they  interpret  this  mass  of  sensory  intake 
and  build  up  an  understanding  of  life's  processes. 
In  still  later  years  comes  the  development  of 
collaborative  processes. 

Early  in  this  infantile  evolution,  and  corre- 
sponding to  it,  speech  usually  puts  out  on  the 
plane  at  which  the  child  has  arrived  those  vocal 
expressions  which  indicate  that  plane.  This  vocal 
expression  makes  a  pretty  exact  externalization 
of  the  mental  evolution  which  has  just  preceded. 

Processes  like  these  furnish  the  model  for  pro- 
cedure in  methods  of  educational  development. 
The  normal  speech  of  children,  developing  along 
certain  definite  lines  from  the  simple  to  the  more 
complex,  gives  a  hint  of  method  that  should  be 
accepted  as  guide  in  the  successive  steps  under- 
taken by  the  teacher  in  the  slow  processes  of 
speech  development  in  the  mentally  feeble. 

It  should  be  clear,  then,  that  we  must  start 
with  the  physiological  basis  which  we  find  pres- 
ent ;  that  we  should  emphasize,  amplify,  and  en- 

119 


SPEECH  DEFECTS  IN  CHILDREN 

large  this ;  that,  as  the  growth  or  power  advances, 
we  should  take  the  hint  and  develop  those  func- 
tions that  naturally  show  up  to  the  maximum  of 
efficiency,  until  the  entire  speech  mechanism 
begins  to  function  perfectly.  As  contrasted  with 
the  application  of  normal  phonetics,  this  is  a  slow 
process.  It  has  to  build  up  the  necessary  parts  of 
the  speech  mechanism  before  it  tries  to  make  that 
mechanism  work  correctly. 

8.  A  system  of  phonetic  drill  for  abnormal 
childre7i 

Before  the  drill  is  begun,  the  vocal  history  of 
each  of  the  pupils  must  be  completed.  Then  there 
should  be  a  vocal  examination  to  determine  what 
sounds  and  words  the  pupil  is  capable  of  uttering 
and  to  discover  the  general  and  particular  defects 
of  speech  to  which  he  is  subject. 

Lesson  i.  Repeat  before  the  pupil  the  words  and 
sentences  which  he  is  himself  able  to  pronounce 
most  readily  and  correctly.  This  should  be  done 
three  times  a  day  for  a  week  or  more,  during  periods 
of  fifteen  minutes. 

Lesson  2.  During  Exercise  i,  note  whether  any 
new  mental  capacities  are  brought  to  light.  If  so, 
concentrate  upon  these,  one  by  one,  developing  each 
as  far  as  possible.  This  may  require  six  months,  or 
more. 

120 


ABNORMAL  CHILDREN 

Lesson  3.  After  it  seems  certain  that  all  the  func- 
tions have  appeared  and  have  been  developed  as 
far  as  possible,  then  assign  a  series  of  vowels,  such 
as  ah,  a,  ee,  au,  0,  00.  Have  the  pupils  repeat  these 
by  ones,  then  by  twos,  then  by  threes,  and  finally 
all  together.  Continue  until  all  the  vowels  are  cor- 
rectly pronounced  in  series. 

Lesson  4.  Add  to  the  above  vowels  the  conso- 
nants which  the  pupils  can  already  pronounce.  Have 
these  repeated  several  times  a  day  for  three  weeks. 

Lesson  5.  Try  to  teach  the  pronunciation  of  a  new 
consonant  or  two,  and  have  these  added  to  the  vowel 
series. 

Lesson  6.  Passing  from  the  known  to  the  unknown, 
as  above,  devise  similar  exercises  with  small  words, 
then  with  long  words,  and  finally  with  short  and  long 
sentences. 

g.  Remarkable  progress  of  some  cases 

It  may  assist  and  encourage  the  teacher  to 
enumerate  a  few  actual  cases  which  have  come 
under  the  author's  observation  during  his  use  of 
a  method  of  drill  similar  to  that  just  outlined. 
These  cases  will  illustrate  the  method  and,  at  the 
same  time,  show  its  efficacy.  A  few  will  suffice. 
I  shall  present  one  from  each  of  the  three  large 
classes  already  mentioned  above,  —  idiot,  imbe- 
cile, and  moron,  —  with  one  or  two  from  the  class 
of  special  mental  defect. 

121 


SPEECH  DEFECTS  IN  CHILDREN 

It  should  be  said  that  occasionally  one  has  to 
acknowledge  defeat  in  this  field.  Sometimes  one 
sees  but  little  progress  as  the  reward  for  hard 
labor.  Surprising  improvement  and  permanent 
personality  changes  are  the  rule,  however,  in 
most  cases. 

The  degree  and  kind  of  improvement  in  speech 
and  mentality  which  may  be  expected  to  result 
from  treatment  is  shown  in  the  following  short 
outlines  of  typical  cases :  — 

Case  I.  Diagnosis :  Marked  mental  backward- 
ness. Before  treatment,  this  boy  sat  alone  at 
home,  doing  nothing.  His  speech  consisted  of  a 
few  grunts  and  the  words  "Mama  "  and  *'  Papa." 
In  the  garden  he  never  used  the  paths,  but  walked 
indiscriminately  upon  flower  beds  and  plants.  Dis- 
tance from  the  city  prevented  completion  of 
drill,  but  the  boy's  speech  is  now  much  clearer 
and  he  has  several  monosyllabic  words.  He  is 
now  careful  to  use  the  paths  in  the  garden,  he 
follows  his  father  about  the  house  and  imitates 
him  at  work,  and  he  has  several  other  minor  in- 
terests. 

Case  2.  Diagfiosis:  Imbecile.  The  most  pain- 
ful feature  of  this  child's  case  before  treatment 
was  begun  was  the  fact  that  she  was  constantly 
in  motion,  incessantly  turning  and  twisting.  Fur- 

122 


ABNORMAL  CHILDREN 

thermore,  she  was  very  destructive.  Hence  her 
mother  was  ashamed  to  take  her  out  of  the  house. 
She  seemed  observing,  but  she  had  an  extremely 
small  vocabulary.  This  case  was  given  treatment 
for  over  a  year.  The  girl  now  uses  many  words 
and  is  able  to  put  them  together  into  very  simple 
sentences.  Her  behavior  is  now  quiet  and  well 
controlled.  Those  who  know  her  say  that  she  has 
undergone  a  wonderful  change  in  matters  of  ob- 
servation, understanding,  mimicry,  and  expression. 

Case  J.  Diagnosis:  Moron.  Before  treatment, 
this  boy  spent  all  his  time  at  home,  having  no  in- 
terest in  sports  or  in  other  boyish  activities.  He 
had  no  friends.  He  was  treated  with  the  special 
vocal  drill,  in  a  more  elaborate  form  than  that 
presented  above,  and  in  about  four  months  showed 
marked  mental  improvement,  and  improvement 
which  his  mother  characterizes  as  *'a  tremendous 
change."  He  now  has  numerous  friends,  he  plays 
baseball  and  football,  and  he  attends  the  "  movies  " 
and  social  functions. 

Case  ^.  Diagnosis:  Special  mental  defect.  I 
have  described  this  case  fully  in  a  recent  article,  i 

*  "The  Development  of  a  Mental  Defective  by  Vocal 
Drill,"  by  Walter  B.  Swift,  M.D.  Boston  Medical  and  Surgi- 
cal Journal,  vol.  CLXXiii,  no.  20,  p.  746.  Reprints  gladly 
sent  upon  request. 

123 


SPEECH  DEFECTS  IN  CHILDREN 

It  may  be  summarized  thus  :  A  case  of  defective 
mentality  was  subjected  to  intensive  vocal  drill 
for  eight  months,  with  the  result  of  remarkable 
and  unexpected  mental  development,  showing  in 
new  initiative,  wider  interests,  extended  observa- 
tion, and  minor  manifestations. 

Case  5-  Diagnosis :  Backwardness  in  school. 
This  boy  showed  little  interest  or  progress  at 
school.  He  had,  indeed,  few  interests  of  any  sort 
outside  of  his  home.  His  speech  was  indistinct, 
monotonous,  lacking  in  flexibility,  but  he  did  not 
stutter.  He  was  given  about  six  months  of  vocal 
drill,  with  the  result  that  his  speech  is  now  clear 
and  flexible  and  correct.  He  is  interested  in  school 
work  and  is  making  what  is  called  "  wonderful " 
progress.  He  is  an  apt  stor}^-teller  and  plays  much 
with  other  children.  Almost  all  signs  of  mental 
backwardness  have  been  eliminated. 

All  I  can  hope  to  do  in  these  bare  outlines  is 
to  focus  attention  upon  the  fact  of  mental  devel- 
opment under  vocal  drill.  I  hope  to  present  these 
and  other  cases  in  greater  detail  in  a  later  vol- 
ume. At  present,  I  am  not  seeking  to  gain  for 
this  new  method  the  credit  it  deserves.  I  shall 
be  content  if  what  I  have  said  leads  others  to  try 
out  the  method  for  themselves.  Seeing  is  believ- 

124 


ABNORMAL  CHILDREN 

ing,  and  it  is  only  fair  to  say  that  some  of  the 
results  which  have  been  attained  can  be  believed 
only  by  those  who  have  seen  them.  Critics  of  the 
method,  therefore,  should  not  content  themselves 
with  hearsay  or  with  even  such  a  report  upon  the 
work  as  has  been  here  given.  They,  too,  should 
see  the  work  and  the  results  with  their  own  eyes 
before  they  speak  in  praise  or  blame. 


OUTLINE 

I.  IMPORTANCE  OF  GOOD  HABITS  OF  SPEECH 

1.  Speech  habits  of  childhood  hard  to  eradicate  .  2 

2.  Some  become  permanent  defects 4 

3.  Defective  speech  marks  the  inejB&cient  worker. .  6 

4.  Social  success  dependent  upon  speech 8 

5.  Bad  habits  of  speech  impede  education 9 

II.  METHODS  OF  CORRECTING  DEFECTS  OF 
SPEECH 

1.  Some  general  methods.  Dividing  classes 14 

2.  Modern  treatment  of  stuttering 16 

3.  Treatment  of  phonetic  defects 26 

4.  Management  of  the  special  class 28 

5.  How  parents  can  help 31 

6.  Function  of  the  school  physician 33 

7.  What  the  superintendent  should  do 35 

8.  Advice  from  the  medical  expert  in  speech 38 

9.  When  to  return  cases  to  the  regular  grades 40 

10.  Value  of  records  on  all  cases 42 

III.  THE  ELIMINATION  OF  MINOR  SPEECH 
DISORDERS 

1.  NasaHty 46 

2.  Monotony 5° 

3.  Harshness  and  Hoarseness 55 

127 


OUTLINE 

4.  Hasty  speech 60 

5.  Slovenly  speech 65 

IV.  HOW  THE  TEACHER  MAY  ACQUIRE  A 
PROPER  STANDARD  OF  SPEECH 

1.  Time  spent  in  regular  grade  work 69 

2.  Value  of  elocution,  music,  psychology 70 

3.  Phonetics  not  to  be  learned  from  books 72 

4.  Special  training  for  the  correction  of  stutterers.  74 

5.  Special  training  for  the  "special  class" 75 

6.  Where  to  go  for  training 76 

7.  Is  medical  knowledge  necessary? 78 

8.  Value  of  work  in  a  special  chnic 80 

9.  Visiting  other  schools 82 

10.  The  pitfalls  for  the  poorly  trained  teacher Ss 

V.  SPEECH   IMPROVEMENT  IN  KINDERGARTEN 
AND  ELEMENTARY  GRADES 

1.  Importance  of  the  child's  speech  environment . .  90 

2.  Importance  of  the  period  before  speech  begins .  92 

3.  The  earliest  utterances  —  Source,   Form,   Sig- 
nificance    94 

4.  Simple  speech.   How  to  amplify  it 96 

5.  Delayed  speech  and  its  causes 99 

6.  Early  speech  defects  and  what  they  lead  to. . . .  100 

7.  Special  methods  in  individual  cases 104 

8.  Danger  of  leaving  defects  to  be  "outgrown". . .  106 

9.  How  to  raise  the  speech  standard  in  the  class- 
room    107 

10.  Value  of  correct  early  standards 109 

128 


OUTLINE 


VI.  SPEECH  DISORDERS  AMONG  ABNORMAL 
CHILDREN  AND  HOW  TO  TREAT  THEM 

1.  Speech  forms  among  the  feeble-minded iii 

2.  Speech  in  the  mental  defective 1 13 

3.  The  basis  of  abnormal  speech 113 

4.  Normal  phonetics  not  suited  to  treatment  of 
abnormal  minds 115 

5.  Mental  background  assumed  in  normal  phonetics  116 

6.  Actual  mental  backgrounds  in  abnormal  minds.  117 

7.  Physiological  basis  for  the  treatment  of  mental 
defectives 119 

8.  A  system  of  phonetic  drill  for  abnormal  children  120 

9.  Remarkable  progress  of  some  cases 121 

10.  A  few  typical  cases 122 


RIVERSIDE   EDUCATIONAL   MONOGRAPHS 

Edited  by  HENRY  SUZZALLO 

Andress's  The  Teaching  of  Hygiene  in  the  Grades  $  .75 
Atwood's  The  Theory  and  Practice  of  the  Kindergarten  .75 
Bailey's  Art  Education  .75 
Betts's  New  Ideals  in  Rural  Schools  .75 
Betts's  The  Recitation  .75 
Bloomfield's  Vocational  Guidance  of  Youth  .7s 
Cabot's  Volunteer  Help  to  the  Schools  .75 
Campagnac's  The  Teaching  of  Composition  .40 
Cole's  Industrial  Education  in  Elementary  Schools  .40 
Cooley's  Language  Teaching  in  the  Grades  .40 
Cubberley's  Changing  Conceptions  of  Education  .40 
Cubberley's  The  Improvement  of  Rtiral  Schools  .40 
Dewey's  Interest  and  Effort  in  Education  .75 
Dewey's  Moral  Principles  in  Education  ,40 
Dooley's  The  Education  of  the  Ne'er-Do-Well  .75 
Earhart's  Teaching  Children  to  Study  .75 
Eliot's  Education  for  Efficiency  ^o 
Eliot's  Concrete  and  Practical  in  Modem  Education  .40 
Emerson's  Education  .40 
Evans's  The  Teaching  of  High  School  Mathematics  .40 
Fairchild's  The  Teaching  of  Poetry  in  the  High  School  .75 
Fiske's  The  Meaning  of  Infancy  .40 
Freeman's  The  Teaching  of  Handwriting  .75 
Haliburton  and  Smith's  Teaching  Poetry  in  the  Grades  .75 
Hartwell's  The  Teaching  of  History  ^o 
Haynes's  Economics  in  the  Secondary  School  .75 
Hill's  The  Teaching  of  Civics  .75 
Home's  The  Teacher  as  Artist  ^o 
Hyde's  The  Teacher's  Philosophy  .40 
Jenkins's  Reading  in  the  Primary  Grades  .75 
Kendall  and  Stryker's  History  in  the  Elementary  Grades  .75 
Kilpatrick's  The  Montessori  System  Examined  .40 
Leonard's  English  Composition  as  a  Social  Problem  .  .75 
Lewis's  Democracy's  High  School  .75 
Maxwell's  The  Observation  of  Teaching  .75 
Meredith's  The  Educational  Bearings  of  Modern  Psy- 
chology .75 
Palmer's  Ethical  and  Moral  Instruction  in  the  Schools  .40 
Palmers  Self-Cultivation  in  English  w|0 
Palmer's  The  Ideal  Teacher  .40 
Palmer's  Trades  and  Professions  .40 
Perry's  Status  of  the  Teacher  .40 
Prosser's  The  Teacher  and  Old  Age  .75 
Russell's  Economy  in  Secondary  Education  ^o 
Smith's  Establishing  Industrial  Schools  .75 
Snedden's  The  Problem  of  Vocational  Education  .40 
Suzzallo's  The  Teaching  of  Primary  Arithmetic  .75 
Suzzallo's  The  Teaching  of  Spelling  .75 
Swift's  Speech  Defects  in  School  Children  .7S 
Terman's  The  Teacher's  Health  .75 
Thomdike's  Individuality  .40 
Trowbridge's  The  Home  School  .75 
Weeks's  The  People's  School  .75 

3016 


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